Evan Craig Wisner, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801104507 Issued in MI

Practice address

560 Meadow LN
Hastings, MI 49058-8837

Phone

(269) 908-0119

NPI assigned

Nov 24, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Evan Craig Wisner LLC

  • Clinical Social Worker
  • Hastings, MI
  • NPI 1073199881
  NPD Authorized official
• Hoxworth Counseling Services, LLC

  • Counseling Psychologist
  • Middleville, MI
  • NPI 1568958718

  Clinical

  NPD (past)

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

{
    "created_epoch": "1574553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1447896550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 MEADOW LN",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490588837",
            "telephone_number": "269-908-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 MEADOW LN",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490588837",
            "telephone_number": "269-908-0119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 E Main St Ste B",
            "address_purpose": "LOCATION",
            "city": "Middleville",
            "state": "MI",
            "postal_code": "493338391",
            "country_code": "US",
            "telephone_number": "269-205-2402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISNER",
        "first_name": "EVAN",
        "middle_name": "CRAIG",
        "name_prefix": "Mr.",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-24",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801104507",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801104507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS - BOARD OF SOCIAL WORK",
            "identifier": "6801104507",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Wilson
• Steven Wilson
• Melissa M Winger, DO
• Caitlin Elise-Nosanov Winsor, OD
• Camie Jean Wisinski, CNM
• Womens Health First PC
• Beverly J. Wood
• Jimmie Daniel Woodall, DO
• Woodlawn Meadows Retirement Village
• Woodlawn Meadows Retirement Village

• Clinical Social Worker in Hastings, MI
• Providers in Hastings, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.