Kimberly Wisniewski, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401005748 Issued in MI

Practice address

1 Ford PL
1C
Detroit, MI 48202-3450

Phone

(313) 874-3094

Fax

(313) 874-9149

NPI assigned

Nov 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Supportive Care I of Michigan PCGroup PAC ID 9638554298, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwisniewski13225@direct.hfhs.org

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.

• Henry Ford Health System

  • Clinical Psychologist
  • Detroit, MI
  • NPI 1114001468

  Professional

  Medicare reassignment Care Compare group NPD
• Supportive Care I of Michigan PC

  • Clinical Psychologist
  • Iron River, MI
  • NPI 1548995608
  Medicare reassignment Care Compare group NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1851462543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39450 W 12 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773600",
            "telephone_number": "248-661-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FORD PL",
            "address_2": "1C",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-3094",
            "fax_number": "313-874-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "KIMBERLY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401005748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwisnie1@hfhs.org",
            "affiliation": "N",
            "address_1": "1 Ford Pl",
            "address_2": "1c",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482023450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dwight Wise
• Jacquelyn L. Wise, LLMSW
• Stefanie Lyn Wise, M.D.
• Melissa Wiseheart
• Edward Wisniewski, PA-C
• Mary Kathryn Wisniewski, LBSW
• Trisha Ann Wisniewski
• Barbara Addison Witalec, PT
• Allyn Singer Prout Witchell, MAMFT
• Dajuana Witcher

• Professional Counselor in Detroit, MI
• Providers in Detroit, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.