Active NPI
Eric Wiszczur
- Counselor
- Wyoming, MI
National Provider Identifier
1235560152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6401013963
- Practice address
- 1843 R W Berends Dr SW
Wyoming, MI 49519-4955 - Phone
- (800) 693-1916
- NPI assigned
- Dec 3, 2013
- Last updated
- Aug 30, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401013963 | MI | Primary |
| Mental Health Counselor | 101YM0800X | NU |
Addresses
Primary practice location
1843 R W Berends Dr SW
Wyoming, MI 49519-4955
Mailing address
3733 Piute Dr SW
Grandville, MI 49418-1950
Phone (616) 510-0511
Other practice location 1
611 N State St
Stanton, MI 48888-9702
Phone (989) 831-7520
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Great Lakes Psychology Group
- Community/Behavioral Health Agency
- Clarkston, MI
- NPI 1679739700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693353600000",
"number": "1235560152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3733 PIUTE DR SW",
"city": "GRANDVILLE",
"state": "MI",
"postal_code": "494181950",
"telephone_number": "616-510-0511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1843 R W BERENDS DR SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "495194955",
"telephone_number": "800-693-1916"
}
],
"practiceLocations": [
{
"address_1": "611 N State St",
"address_purpose": "LOCATION",
"city": "Stanton",
"state": "MI",
"postal_code": "488889702",
"country_code": "US",
"telephone_number": "989-831-7520",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WISZCZUR",
"first_name": "ERIC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-12-03",
"last_updated": "2023-08-30",
"certification_date": "2023-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401013963",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.