Kenitres Marcell Wiley, MS, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

82487 Issued in TX

Practice address

1001 Custer Rd
Plano, TX 75075-8309

Phone

(469) 752-6716

NPI assigned

Nov 6, 2019

Last updated

Jan 19, 2023By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1821633454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 S GOLIAD ST UNIT 1745",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874061",
            "telephone_number": "972-813-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 CUSTER RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750758309",
            "telephone_number": "469-752-6716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "437 Spring Air Dr",
            "address_purpose": "LOCATION",
            "city": "Allen",
            "state": "TX",
            "postal_code": "750025319",
            "country_code": "US",
            "telephone_number": "214-794-4825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILEY",
        "first_name": "KENITRES",
        "middle_name": "MARCELL",
        "name_prefix": "Mrs.",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-06",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "82487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Plano, TX
• Providers in Plano, TX by specialty
• Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.