Individual provider Active NPI

Leslie Mae Wireman, LLP

  • Clinical Psychologist
  • Jackson, MI
National Provider Identifier
1417084849
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301010207 Issued in MI
Practice address
914 Airport Rd
Jackson, MI 49202
Phone
(517) 499-2976
NPI assigned
Feb 27, 2007
Last updated
Aug 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301010207 MI Primary

Addresses

Primary practice location

914 Airport Rd
Jackson, MI 49202

Mailing address

PO Box 10
Mason, MI 48854-0010

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
6301010207MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wireman Counseling Innovations LLC CurrentSince Aug 11, 2019 Accepting new patients
Karen Gallagher LMSW Acsw Professional Counseling SRVS LLC PastSince Jan 1, 2009 Accepting new patients

Locations

914 Airport Rd
Jackson, MI 49202
Phone (517) 499-2976

915 Airport Rd
Jackson, MI 49202
Phone (517) 206-3016

915 Airport Rd
Ste 8
Jackson, MI 49202
Phone (517) 745-8682

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1417084849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 AIRPORT RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49202",
            "telephone_number": "517-499-2976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIREMAN",
        "first_name": "LESLIE",
        "middle_name": "MAE",
        "name_prefix": "Ms.",
        "credential": "LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301010207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; 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.