Individual provider Active NPI

James M Wise, LMFTA

  • Mental Health Counselor
  • Winston Salem, NC
National Provider Identifier
1265201974
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10938A Issued in NC
Practice address
942 W 4TH St
Winston Salem, NC 27101-2582
Phone
(336) 355-8244
NPI assigned
Dec 21, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10938A NC Primary

Addresses

Primary practice location

942 W 4TH St
Winston Salem, NC 27101-2582

Mailing address

1941 Denise LN
Winston Salem, NC 27127-8750
Phone (423) 707-5447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10938ANCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1265201974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 DENISE LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271278750",
            "telephone_number": "423-707-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 W 4TH ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271012582",
            "telephone_number": "336-355-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "JAMES",
        "middle_name": "M",
        "credential": "LMFTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "10938A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.