Katherine Wise, MA, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH20132 Issued in FL

Practice address

1726 Kingsley Ave
Orange Park, FL 32073-4463

Phone

(904) 278-5644

NPI assigned

Feb 23, 2022

Sex

Female

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

Enrolled in FL

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

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychological Services of Jacksonville LLCGroup PAC ID 4880606987, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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

• Psychological Services of Jacksonville LLC

  • Clinical Psychologist
  • Orange Park, FL
  • NPI 1528005311
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1366198889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 KINGSLEY AVE STE 2",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734411",
            "telephone_number": "904-278-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734463",
            "telephone_number": "904-278-5644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Biltmore Way Ste 109",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331345724",
            "country_code": "US",
            "telephone_number": "415-424-4266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "KATHERINE",
        "credential": "MA, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH20132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristopher Edward Wilson, MOT
• Robert Anthony Wilson II, PHARMD
• Tia Wilson, LMHC
• Windows of Hope Inc.
• Jennifer Adams Winston, D.P.T.
• Nicole Juline Wissel, APRN
• Anne H Witt, ARNP
• Mara Jane Wojtowicz
• Shawn Wolf, ATC
• Nicholas Michael Wolfe

• Mental Health Counselor in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.