Amy Wiley Ma LCPC P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180007352 Issued in IL

Legal business name

AMY WILEY MA LCPC P.C.

Practice address

750 Almar Pkwy
Suite 205
Bourbonnais, IL 60914-2315

Phone

(815) 939-4806

NPI assigned

Jun 20, 2016

Organization subpart

No

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

Authorized official

Name

Amy Wiley, LCPC

Title

Mental Health Counselor

Phone

(815) 939-4806

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477526400000",
    "number": "1972953099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 ALMAR PKWY",
            "address_2": "SUITE 205",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 ALMAR PKWY",
            "address_2": "SUITE 205",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142315",
            "telephone_number": "815-939-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY WILEY MA LCPC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-10-27",
        "status": "A",
        "authorized_official_last_name": "WILEY",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "815-939-4806",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180007352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.