Active NPI
Nancy L Wiseman, L.C.S.W.
- Clinical Social Worker
- Saint Charles, MO
National Provider Identifier
1275675142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 005343
- Practice address
- 316 S 2ND St
Suite a
Saint Charles, MO 63301-3402 - Phone
- (636) 949-6605
- Fax
- (636) 949-6607
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 005343 | MO | Primary |
Addresses
Primary practice location
316 S 2ND St
Suite a
Saint Charles, MO 63301-3402
Mailing address
PO Box 69
Saint Charles, MO 63302-0069
Phone (636) 949-6605
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 |
|---|---|---|---|
| 005343 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363046400000",
"number": "1275675142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 69",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633020069",
"telephone_number": "636-949-6605",
"fax_number": "636-949-6607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 S 2ND ST",
"address_2": "SUITE A",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633013402",
"telephone_number": "636-949-6605",
"fax_number": "636-949-6607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISEMAN",
"first_name": "NANCY",
"middle_name": "L",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2013-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "005343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.