Active NPI
Nicole Lynne Wiesen, MSW
- Social Worker
- Atlanta, GA
National Provider Identifier
1477971000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 469
- Practice address
- 214 Druid Oaks NE
Atlanta, GA 30329-3256 - Phone
- (404) 603-6606
- NPI assigned
- Apr 1, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | SW3351 | FL | |
| Social Worker | 104100000X | 469 | CA | Primary |
Addresses
Primary practice location
214 Druid Oaks NE
Atlanta, GA 30329-3256
Mailing address
214 Druid Oaks NE
Atlanta, GA 30329-3256
Phone (404) 603-6606
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
| License | State | Type | Specialty |
|---|---|---|---|
| SW3351 | FL | MD | Mental Health Counselor |
| 469 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396310400000",
"number": "1477971000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 DRUID OAKS NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303293256",
"telephone_number": "404-603-6606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 DRUID OAKS NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303293256",
"telephone_number": "404-603-6606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIESEN",
"first_name": "NICOLE",
"middle_name": "LYNNE",
"name_prefix": "Mrs.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-01",
"last_updated": "2014-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "SW3351",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.