Individual provider Active NPI

Li Wiesel

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Petersburg, FL
National Provider Identifier
1700718202
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Practice address
4010 Central Ave
Saint Petersburg, FL 33711-1239
Phone
(727) 900-1326
Fax
(727) 256-0039
NPI assigned
Jun 1, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

4010 Central Ave
Saint Petersburg, FL 33711-1239

Mailing address

6306 S Macdill Ave Apt 804
Tampa, FL 33611-5049
Phone (727) 900-1326

Other names 1

  • Li Wang Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1780272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1700718202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6306 S MACDILL AVE APT 804",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336115049",
            "telephone_number": "727-900-1326",
            "fax_number": "727-256-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 CENTRAL AVE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337111239",
            "telephone_number": "727-900-1326",
            "fax_number": "727-256-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESEL",
        "first_name": "LI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LI",
            "last_name": "WANG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.