NPIMap

Organization Active NPI

Paula Wisdom, LLC

  • Clinical Social Worker
  • Potosi, MO
National Provider Identifier
1689975724
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PAULA WISDOM, LLC
Practice address
11667 Jinkerson Rd
Potosi, MO 63664-3012
Phone
(573) 436-4809
NPI assigned
Nov 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Authorized official

Name
Paula Jean Wisdom, LCSWNPI 1689895286
Title
Owner
Phone
(573) 436-4809

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

11667 Jinkerson Rd
Potosi, MO 63664-3012

Mailing address

11667 Jinkerson Rd
Potosi, MO 63664-3012
Phone (573) 436-4809

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294012800000",
    "number": "1689975724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11667 JINKERSON RD",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636643012",
            "telephone_number": "573-436-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11667 JINKERSON RD",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636643012",
            "telephone_number": "573-436-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULA WISDOM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-05",
        "last_updated": "2011-01-03",
        "status": "A",
        "authorized_official_last_name": "WISDOM",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-436-4809",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potosi, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; 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.