Mark Stephen Wise

Primary specialty

PsychoanalystTaxonomy code 102L00000X

License

LPC014257 Issued in GA

Practice address

2501 E Piedmont Rd Ste 202
Marietta, GA 30062-7758

Phone

(470) 435-1547

NPI assigned

Dec 11, 2023

Last updated

Dec 11, 2023By the provider in NPPES

Sex

Male

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Marietta Associated Psychological Services Inc

  • Clinical Psychologist
  • Marietta, GA
  • NPI 1174953780
  NPD (past)

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1871360727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 E PIEDMONT RD STE 202",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300627758",
            "telephone_number": "470-435-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 E PIEDMONT RD STE 202",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300627758",
            "telephone_number": "470-435-1547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "479 Cotter St",
            "address_purpose": "LOCATION",
            "city": "Ringgold",
            "state": "GA",
            "postal_code": "307362337",
            "country_code": "US",
            "telephone_number": "470-435-1547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "MARK",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "GA",
            "license": "LPC014257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Neil Winter, M.D.
• Norman Michael Winter Jr., DMD
• Sarah Winter, PTA
• Stephanie Winter, D.C.
• Katlin Wise
• Tanesha Wise
• Wishing Well Counseling & Consulting (Wishing Well ATL)
• Angelina Elizabeth Witbeck, PSY.D.
• Witkiewicz Enterprises, Inc (Comfort Keepers)
• Witkiewicz Enterprises, Inc. (Comfort Keepers)

• Psychoanalyst in Marietta, GA
• Providers in Marietta, GA by specialty
• Psychoanalyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.