Jennifer Ann Wisniewski, M.A., L.L.P.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301013497 Issued in MI

Practice address

2090 Celebration Dr NE Ste 212
Grand Rapids, MI 49525-9200

Phone

(616) 307-8385

NPI assigned

Oct 5, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1223164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223164800000",
    "number": "1235380528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 RYPENS DR NW",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "495342463",
            "telephone_number": "616-307-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 CELEBRATION DR NE STE 212",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259200",
            "telephone_number": "616-307-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.A., L.L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-05",
        "last_updated": "2008-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Wise
• Phillip Gregory Wise, M.D.
• Caleb James Wisemccann, LLMSW
• Wishing Well, Inc. (Detox For Healthy Living)
• Jerome J Wisneski, MD
• Luke Wisniewski, DO
• Mary L Wisniewski, PA-C
• Rachel Wisniewski, OTR
• Sydney Wisniewski, LLMSW
• Heather Wiszczur-Johnson, LMSW, CAADC

• Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2008; 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.