Individual provider Active NPI

Edith Morgan Wierzbicki

  • Mental Health Counselor
  • Port Charlotte, FL
National Provider Identifier
1457069353
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH17114 Issued in FL
Practice address
270 E Tarpon Blvd NW
Port Charlotte, FL 33952-6573
Phone
(239) 207-7575
NPI assigned
Nov 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH17114 FL Primary

Addresses

Primary practice location

270 E Tarpon Blvd NW
Port Charlotte, FL 33952-6573

Mailing address

270 E Tarpon Blvd NW
Port Charlotte, FL 33952-6573
Phone (239) 207-7575

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
MH17114FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1457069353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 E TARPON BLVD NW",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526573",
            "telephone_number": "239-207-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 E TARPON BLVD NW",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526573",
            "telephone_number": "239-207-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERZBICKI",
        "first_name": "EDITH",
        "middle_name": "MORGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.