Active NPI
Jonathan Wiesner, CAC II
- Addiction (Substance Use Disorder) Counselor
- Lawrenceville, GA
National Provider Identifier
1497160394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1971
- Practice address
- 250 Scenic Hwy
Lawrenceville, GA 30046-5675 - Phone
- (678) 442-5800
- NPI assigned
- Jun 30, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1971 | GA | Primary |
Addresses
Primary practice location
250 Scenic Hwy
Lawrenceville, GA 30046-5675
Mailing address
250 Scenic Hwy S
Lawrenceville, GA 30046-5675
Phone (678) 442-5800
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 |
|---|---|---|---|
| 1971 | GA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404086400000",
"number": "1497160394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 SCENIC HWY S",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300465675",
"telephone_number": "678-442-5800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 SCENIC HWY",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300465675",
"telephone_number": "678-442-5800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIESNER",
"first_name": "JONATHAN",
"name_prefix": "Mr.",
"credential": "CAC II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-30",
"last_updated": "2014-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "GA",
"license": "1971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.