Monique Machelle Wisness, LSW

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

45600224 Issued in ND

Practice address

1008 4TH Ave SE Apt 116
Watford City, ND 58854-7732

Phone

(701) 566-9020

NPI assigned

Jun 24, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• McKenzie County Social Services

  • Case Management Agency
  • Watford City, ND
  • NPI 1598177156
  NPD (past)
• McKenzie County Social Services

  • Case Management Agency
  • Watford City, MS
  • NPI 1548716285
  NPD (past)

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1821449455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 4TH AVE SE APT 116",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "588547732",
            "telephone_number": "701-566-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 4TH AVE SE APT 116",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "588547732",
            "telephone_number": "701-566-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNESS",
        "first_name": "MONIQUE",
        "middle_name": "MACHELLE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ND",
            "license": "3648",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "ND",
            "license": "45600224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1460241",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Vega
• Riley Rae Veis
• Wade Darr LLC
• Jenna M Wahlstrom, PHARMD
• Michelle Wisehart, BA

• Case Manager/Care Coordinator in Watford City, ND
• Providers in Watford City, ND by specialty
• Case Manager/Care Coordinator in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.