Active NPI
Betsy Lee Wicklein, L.P.C.
- Professional Counselor
- Watkinsville, GA
National Provider Identifier
1710070040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC003095
- Practice address
- 1030 Village Dr
Watkinsville, GA 30677-6004 - Phone
- (706) 769-1718
- Fax
- (706) 769-4535
- NPI assigned
- Sep 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC003095 | GA | Primary |
Addresses
Primary practice location
1030 Village Dr
Watkinsville, GA 30677-6004
Mailing address
1030 Village Dr
P.O. Box 626
Watkinsville, GA 30677-6004
Phone (706) 769-1718
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC003095 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stresscare, Inc. | Past | Accepting new patients | |
| Douglas W Duke LPC | Professional | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Social Worker
- Watkinsville, GA
- NPI 1023086105
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710070040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1030 VILLAGE DR",
"address_2": "P.O. BOX 626",
"city": "WATKINSVILLE",
"state": "GA",
"postal_code": "306776004",
"telephone_number": "706-769-1718",
"fax_number": "706-769-4535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 VILLAGE DR",
"city": "WATKINSVILLE",
"state": "GA",
"postal_code": "306776004",
"telephone_number": "706-769-1718",
"fax_number": "706-769-4535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICKLEIN",
"first_name": "BETSY",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC003095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watkinsville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.