Individual provider Active NPI

Stephen Thomas Wize, LCSW

  • Clinical Social Worker
  • Cranberry Township, PA
National Provider Identifier
1942630314
Registry record updated Nov 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW017900 Issued in PA
Practice address
20399 RT 19, Brandt Dr, One Landmark North
Suite 205a
Cranberry Township, PA 16066-4139
Phone
(724) 544-0596
Fax
(724) 772-8069
NPI assigned
Nov 20, 2013
Last updated
Nov 20, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW017900 PA Primary

Addresses

Primary practice location

20399 RT 19, Brandt Dr, One Landmark North
Suite 205a
Cranberry Township, PA 16066-4139

Mailing address

20399 RT 19, Brandt Dr, One Landmark North
Suite 205a
Cranberry Township, PA 16066-4139

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
CW017900PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Fitness, LLC Clinical Past Accepting new patients
Quantum Revolution Counseling Services Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1384905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384905600000",
    "number": "1942630314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20399 RT 19, BRANDT DR, ONE LANDMARK NORTH",
            "address_2": "SUITE 205A",
            "city": "CRANBERRY TOWNSHIP",
            "state": "PA",
            "postal_code": "160664139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20399 RT 19, BRANDT DR, ONE LANDMARK NORTH",
            "address_2": "SUITE 205A",
            "city": "CRANBERRY TOWNSHIP",
            "state": "PA",
            "postal_code": "160664139",
            "telephone_number": "724-544-0596",
            "fax_number": "724-772-8069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIZE",
        "first_name": "STEPHEN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-20",
        "last_updated": "2013-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranberry Township, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; 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.