Individual provider Active NPI

Jacquelyn Wiles, LPC

  • Mental Health Counselor
  • Englewood, NJ
National Provider Identifier
1912606476
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
37AC00672500 Issued in NJ
Practice address
4 W Palisade Ave # 1083
Englewood, NJ 07631-2720
Phone
(908) 671-1479
NPI assigned
Feb 23, 2023
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 37AC00672500 NJ Primary

Addresses

Primary practice location

4 W Palisade Ave # 1083
Englewood, NJ 07631-2720

Mailing address

4 W Palisade Ave # 1083
Englewood, NJ 07631-2720
Phone (908) 671-1479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
37AC00672500NJMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1912606476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 W PALISADE AVE # 1083",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312720",
            "telephone_number": "908-671-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 W PALISADE AVE # 1083",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312720",
            "telephone_number": "908-671-1479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILES",
        "first_name": "JACQUELYN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-23",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00672500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; 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.