Kady Maxwell Wise, LPC-

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

83704 Issued in TX

Practice address

2520 Longview St Ste 307
Austin, TX 78705-4202

Phone

(512) 607-9360

Fax

(877) 775-9422

NPI assigned

May 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kady Maxwell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 20, 2024 through Oct 20, 2026

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.

• Weber Wellness PLLC

  • Professional Counselor
  • Austin, TX
  • NPI 1144733270
  NPD (past)

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1356963813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 HUNTERS CIR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756057473",
            "telephone_number": "903-241-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 LONGVIEW ST STE 307",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787054202",
            "telephone_number": "512-607-9360",
            "fax_number": "877-775-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "KADY",
        "middle_name": "MAXWELL",
        "credential": "LPC-",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-07",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "83704",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "83704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KADY",
            "last_name": "MAXWELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brenna Christine Wise, NP
• Chrissie Wise
• Dara J Wise, CTRS
• Holly Ann Wise, RD, LD
• James L Wise, M.D.
• Kendal Brooke Wise
• Laura Wise, MD
• Macy Lauren Wise
• Madison Wise, LPC-A
• Michelle M Wise, LPC

• Professional Counselor in Austin, TX
• Providers in Austin, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.