Gabriell Lucille Wise, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S.2208229 Issued in OH

Practice address

2660 W Hume Rd
Lima, OH 45806-9446

Phone

(574) 721-2436

NPI assigned

Oct 4, 2023

Last updated

Oct 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/pathihc/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Phoenix Group Home, LLC

  dba PATH Integrated Healthcare

  • Community/Behavioral Health Agency
  • Portsmouth, OH
  • NPI 1083146013
  NPD (past)
• Phoenix Group Home, LLC

  dba Path Behavioral Health- SUD

  • Substance Abuse Rehabilitation Facility
  • Cincinnati, OH
  • NPI 1336654854

  Community/Behavioral Health

  NPD (past)

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1619757838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 W HUME RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458069446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 W HUME RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458069446",
            "telephone_number": "574-721-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "GABRIELL",
        "middle_name": "LUCILLE",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.2208229",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Lynn Wireman
• Nancy R. Wischmeyer-Schaub
• Wise Footwear, LLC
• Danielle Wise, PHARMD
• David M Wise
• Victoria Alane Wise, CNP
• Stephanie Ann Wiseman
• Jeffrey M Wisser, D.O.
• Kayla Wita
• Sarah A Wittman

• Clinical Social Worker in Lima, OH
• Providers in Lima, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.