Susan Wiley

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

XL4841 Issued in ME

Practice address

125 Presumpscot St
Portland, ME 04103-5225

Phone

(207) 871-1000

NPI assigned

Feb 21, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Cornerstone Behavioral Healthcare, LLC

  • Community/Behavioral Health Agency
  • Bangor, ME
  • NPI 1215102850
  Medicare reassignment NPD
• Meredith Howe, LMFT, LLC

  • Marriage & Family Therapist
  • Portland, ME
  • NPI 1881270064
  NPD (past)

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1760921969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 BROADWAY APT 4",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041065720",
            "telephone_number": "207-899-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PRESUMPSCOT ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041035225",
            "telephone_number": "207-871-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "XL4841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariel E Wilcox, R.N.
• Gilbert M Wilcox, MD
• Laura Beth Wilds, ACNPC-AG, APRN-CNP
• Wildwood Medicine
• Carmela Marie Wiles, OT
• Peter David Wilk, MD
• James A Wilkerson, MD
• Kathryn Marie Wilkin, MD
• Abigail R Wilkins Bishop, M.A.
• Zachariah Wilkins, LCPC-C

• Professional Counselor in Portland, ME
• Providers in Portland, ME by specialty
• Professional Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.