Active NPI
James M Wise, LMFTA
- Mental Health Counselor
- Winston Salem, NC
National Provider Identifier
1265201974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 10938A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 10938A | NC | MD | Mental 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.