Individual provider Active NPI

Matthew Lane Wheeler, LPC

  • Professional Counselor
  • Mesa, AZ
National Provider Identifier
1316656895
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-16749 Issued in AZ
Practice address
1745 S Alma School Rd Ste 230
Mesa, AZ 85210-3013
Phone
(480) 382-9199
NPI assigned
Nov 23, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-16749 AZ Primary

Addresses

Primary practice location

1745 S Alma School Rd Ste 230
Mesa, AZ 85210-3013

Mailing address

9928 E Posada Ave
Mesa, AZ 85212-2024
Phone (602) 571-3959

Other identifiers 1

IdentifierTypeStateIssuer
LPC-16749OtherAZARIZONA BOARD OF BEHAVIORAL HEALTH

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
LPC-16749AZMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1316656895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9928 E POSADA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122024",
            "telephone_number": "602-571-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 S ALMA SCHOOL RD STE 230",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103013",
            "telephone_number": "480-382-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "MATTHEW",
        "middle_name": "LANE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-23",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-16749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA BOARD OF BEHAVIORAL HEALTH",
            "identifier": "LPC-16749",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.