Anita L Wigfall

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

3220 E Jefferson Blvd
South Bend, IN 46615-3028

Phone

(574) 222-2466

NPI assigned

Feb 8, 2021

Last updated

Feb 8, 2021By 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

Practice roles

Locations

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.

• Dr Heather Holleman LLC

  • Clinical Psychologist
  • South Bend, IN
  • NPI 1942999636

  Single Specialty

  NPD
• Reflections Counseling

  • Community/Behavioral Health Agency
  • South Bend, IN
  • NPI 1023428711

  Single Specialty

  NPD

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1639761919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25575 ROLLING HILLS DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466289072",
            "telephone_number": "574-850-5766",
            "fax_number": "574-850-5766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 E JEFFERSON BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466153028",
            "telephone_number": "574-222-2466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25575 Rolling Hills Dr",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466289072",
            "country_code": "US",
            "telephone_number": "574-850-5766",
            "fax_number": "574-850-5766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIGFALL",
        "first_name": "ANITA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Wibbens, MD, MBA
• Hailee Widman
• Douglas Eric Widmer, O.D.
• Katie Widup, PHARMD
• Julie A Wieger, DPM FAC FAS
• Haley Rose Wigfall, RBT
• Sydney Rose Wilderman, DO
• Kaitlin Wiley, RD
• Starrse Vershonna Wiley
• Alicia J Wiliams

• Mental Health Counselor in South Bend, IN
• Providers in South Bend, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.