Preston Tyler Wholley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

085020 Issued in NY

Practice address

169 W 133Rd St
New York, NY 10030

Phone

(646) 762-4950

NPI assigned

Mar 27, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: preston.wholley@uram.eclinicaldirectplus.com

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.

• Upper Room AIDS Ministry, Inc. Adult Day Health Care Center.

  • Clinic/Center
  • New York, NY
  • NPI 1417986340

  Clinical

  Medicare reassignment NPD
• Shlomit Levy

  • Preferred Provider Organization
  • New York, NY
  • NPI 1407219447
  NPD (past)

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1326465360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 W 133RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100303301",
            "telephone_number": "646-762-4950",
            "fax_number": "646-762-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 W 133RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10030",
            "telephone_number": "646-762-4950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123-125 West. 124th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10027",
            "country_code": "US",
            "telephone_number": "212-531-1300",
            "fax_number": "212-531-1085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHOLLEY",
        "first_name": "PRESTON",
        "middle_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-27",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089557",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326465360",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whole Connection; Mindful Reflection, LLC
• Whole Mind Psychology, PLLC
• Wholeness Psychotherapy LCSW LLC
• Wholeview Psychological Services, PLLC
• Wholeview Wellness, LLC
• Yuet Yu Whu, RPH
• Asaleeka Whyte-Reyes, LMSW
• Alone Rennordo Whyte
• Claretta S Whyte, LMSW
• Daniel Anthony Joseph Whyte, DC

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.