Shelly Wiewiora LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SHELLY WIEWIORA LLC

Practice address

433 Seminole Rd Ste 101
Norton Shores, MI 49444-3743

Phone

(231) 286-6077

NPI assigned

Sep 18, 2023

Organization subpart

No

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

Authorized official

Name

Shelly Wiewiora, LPCNPI 1225280779

Title

Mental Health Counselor

Phone

(231) 286-6077

Specialties & licenses 1

Addresses

Other names 1

• Personal Growth Therapy Other name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shelly Ann Wiewiora, LPC

  • Professional Counselor
  • Muskegon, MI
  • NPI 1225280779

  Mental Health

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1740068048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 SEMINOLE RD STE 101",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494443743",
            "telephone_number": "231-286-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 SEMINOLE RD STE 101",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494443743",
            "telephone_number": "231-286-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELLY WIEWIORA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2024-01-04",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "WIEWIORA",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "231-286-6077",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Personal Growth Therapy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Personal Growth Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Mental Health Counselor in Norton Shores, MI
• Providers in Norton Shores, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.