Regina Katherine Wisenbaker

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

CSW005046 Issued in GA

Legal business name

REGINA KATHERINE WISENBAKER

Doing business as

Wisenbaker Counseling Services, LLC

Practice address

415 Cowart Ave Ste B
Valdosta, GA 31602-2651

Phone

(229) 630-6587

Fax

(229) 257-0757

NPI assigned

Jan 16, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Regina Katherine Wisenbaker, LCSWNPI 1144654674

Title

Owner

Phone

(229) 630-6587

Specialties & licenses 1

Addresses

Other names 1

• Wisenbaker Counseling Services, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Regina Katherine Wisenbaker, LCSW

  • Clinical Social Worker
  • Valdosta, GA
  • NPI 1144654674
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397001600000",
    "number": "1922420579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 COWART AVE STE B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022651",
            "telephone_number": "229-630-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 COWART AVE STE B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022651",
            "telephone_number": "229-630-6587",
            "fax_number": "229-257-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGINA KATHERINE WISENBAKER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-16",
        "last_updated": "2014-04-09",
        "status": "A",
        "authorized_official_last_name": "WISENBAKER",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "KATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-630-6587",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": "GA",
            "license": "CSW005046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wisenbaker Counseling Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shilpa Narahari Reddy, MD
• Redirect Counseling Services Inc (Redirect Driver Improvement Services)
• Chateris Reed
• Tayler Gail Anne Reed
• Byron Paul Reese, MD
• Caitlyn Christine Register, MSN, APRN, FNP-C
• Jerry Mitchell Register Jr., LCSW
• Kenneth Walker Register, D.C.
• Lindsey Register, M. ED, CF-SLP
• Rehab Engineering LLC

• Community Health Worker in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Community Health Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.