Jason Donald Wisdom, MA, MED., LMFT, BCBA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT-805 Issued in HI

Practice address

98-501 Koauka Loop Apt 305
Aiea, HI 96701-4560

Phone

(360) 470-2183

NPI assigned

Nov 9, 2021

Sex

Male

Sole proprietor

Yes

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

Enrolled in HI

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

Marriage and Family Therapist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Master of Education

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.

• Mental Health Specialty Group PA

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  • Durham, NC
  • NPI 1801472634

  HI, Single Specialty

  Medicare reassignment NPD
• Behaviorzoid LLC

  • Marriage & Family Therapist
  • Kailua, HI
  • NPI 1902670847
  NPD Authorized official

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1871259366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-501 KOAUKA LOOP APT A305",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967015827",
            "telephone_number": "360-470-2183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-501 KOAUKA LOOP APT 305",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967014560",
            "telephone_number": "360-470-2183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Ala Moana Blvd Ste 7400",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968134902",
            "country_code": "US",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISDOM",
        "first_name": "JASON",
        "middle_name": "DONALD",
        "credential": "MA, MED., LMFT, BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-09",
        "last_updated": "2023-07-26",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "HI",
            "license": "MFT-805",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "HI",
            "license": "BA-610",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003128",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miko Willoughby
• Lilly Wilson
• Melanie Wilson
• Jonathon Wimmer
• Kiara Wing
• Leatrice H Wolfe
• Knisha Wolfgang
• Arryel Womble, LCSW
• Alexsi Wong
• Emily Beth Wong, M.D.

• Marriage & Family Therapist in Aiea, HI
• Providers in Aiea, HI by specialty
• Marriage & Family Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.