Amy Jean Wiley, MA LCPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

180.007352 Issued in IL

Practice address

201 Park PL
Suite 24
Bourbonnais, IL 60914-1885

Phone

(815) 935-0333

Fax

(815) 928-9200

NPI assigned

Nov 23, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1619205010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK PL",
            "address_2": "SUITE 24",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141885",
            "telephone_number": "815-935-0333",
            "fax_number": "815-928-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PARK PL",
            "address_2": "SUITE 24",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141885",
            "telephone_number": "815-935-0333",
            "fax_number": "815-928-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "AMY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "MA LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-23",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180.007352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; 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.