Wise Mind Mental Health Clinic, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4342 Issued in WI

Legal business name

WISE MIND MENTAL HEALTH CLINIC, LLC

Practice address

601 E 3Rd St
Marshfield, WI 54449-4512

Phone

(715) 384-0080

Fax

(715) 384-0090

NPI assigned

Dec 2, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Patricia Kay Faber, MSW

Title

Member/Manager

Phone

(715) 384-0080

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396310400000",
    "number": "1215368139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E 3RD ST",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544494512",
            "telephone_number": "715-384-0080",
            "fax_number": "715-384-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E 3RD ST",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544494512",
            "telephone_number": "715-384-0080",
            "fax_number": "715-384-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE MIND MENTAL HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-02",
        "last_updated": "2014-04-01",
        "status": "A",
        "authorized_official_last_name": "FABER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "715-384-0080",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "4342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffanie Jean Wilson
• Karen A. Winch, NP
• Audra Ann Winder, MD
• David Winemiller, PHD
• Angela Kim Wirkus, RD
• Sean P Witte, OTR
• Kristin K Wiza, M.S., CCC-SLP
• Margaret Wolan, O.D.
• Craig A Wolfe, MD
• Franklin W Womble, MD

• Clinical Social Worker in Marshfield, WI
• Providers in Marshfield, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.