Individual provider Active NPI

Judith Kay Wisher, MA, LMHC

  • Mental Health Counselor
  • Daytona Beach, FL
National Provider Identifier
1811298243
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 8904 Issued in FL
Practice address
3875 Tiger Bay Rd
Daytona Beach, FL 32124-1063
Phone
(386) 236-3234
NPI assigned
Nov 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH 8904 FL Primary

Addresses

Primary practice location

3875 Tiger Bay Rd
Daytona Beach, FL 32124-1063

Mailing address

1220 Willis Ave
Box 32
Daytona Beach, FL 32114-2810
Phone (386) 236-3234

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MH 8904FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1811298243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 WILLIS AVE",
            "address_2": "BOX 32",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142810",
            "telephone_number": "386-236-3234",
            "fax_number": "383-236-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3875 TIGER BAY RD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321241063",
            "telephone_number": "386-236-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISHER",
        "first_name": "JUDITH",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "MA, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-17",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 8904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; 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.