Brett Russell Wiley

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

AS180407234 Issued in MI

Practice address

16 Kapplinger Dr
Farwell, MI 48622-9405

Phone

(989) 588-6769

NPI assigned

Jun 22, 2021

Sex

Male

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)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wiley-Gunden Afc

  • Developmental Disabilities Clinic/Center
  • Farwell, MI
  • NPI 1447820618
  NPD Authorized official
• Gunden Afc

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Farwell, MI
  • NPI 1306115894
  NPD (past)

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1275102493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 129",
            "city": "FARWELL",
            "state": "MI",
            "postal_code": "486220129",
            "telephone_number": "989-588-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 KAPPLINGER DR",
            "city": "FARWELL",
            "state": "MI",
            "postal_code": "486229405",
            "telephone_number": "989-588-6769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "BRETT",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MI",
            "license": "AS180407234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Thrush, LPC
• Abby Veit
• Heather Wentworth
• Michael J Wertheimer, MD
• Wiley-Gunden Afc
• Elizabeth Marie Winegar, D.D.S
• Samuel Dominic Zuccala, OTR

• Mental Health Clinic/Center (Including Community Mental Health Center) in Farwell, MI
• Providers in Farwell, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.