MICHAEL RALPH WISELEY LMSW, NPI 1144598715 — TUCSON (AZ)

NPI 1144598715

8+ Years Experience Individual

MICHAEL RALPH WISELEY LMSW

12.09.2011
PROVIDER ENUMERATION DATE
12.09.2011
LAST UPDATE DATE
1144598715
NPI NUMBER

About MICHAEL RALPH WISELEY

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

MICHAEL RALPH WISELEY is a provider established in TUCSON, AZ. The NPI number of MICHAEL RALPH WISELEY is 1144598715 and was assigned on 12.09.2011. The practitioners primary taxonomy code is: 1041C0700X with license number: LMSW-13021 AZ .

Mailing address

  • City: TUCSON
  • State: AZ
  • Postal code: 857132308
  • Phone: 5203235677
  • Address: 1776 S PALO VERDE AVE APT B103

Primary Practice Address

  • Region : TUCSON, AZ
  • NPI : 1144598715
  • Phone : 5207921450
  • Postalcode : 857230001
  • Address : 3601 S 6TH AVE

Provider taxonomy - Social Worker

  • Taxonomy code: 1041C0700X
  • License number: LMSW-13021
  • License state: AZ

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A social worker who holds a master"s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master"s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Contacts:

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  • MICHAEL RALPH WISELEY LMSW
  • Address : 3601 S 6TH AVE
  • Region : TUCSON, AZ
  • NPI : 1144598715
  • Phone : 5207921450
  • Postalcode : 857230001

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address3601 S 6TH AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameTUCSON
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameAZ
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code857230001
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number5207921450
The telephone number associated with the location address of the provider being identified.
NPI1144598715
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 11041C0700X
A social worker who holds a master"s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master"s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Provider Enumeration Date12.09.2011
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated12.09.2011
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)MICHAEL RALPH WISELEY
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address1776 S PALO VERDE AVE APT B103
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameTUCSON
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameAZ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code857132308
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number5203235677
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #11041C0700X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Social Worker
A social worker who holds a master"s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master"s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Provider License Number 1LMSW-13021
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1AZ
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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