BRADLEY G. WISE (NPI# 1194139980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194139980 |
| Entity Type | Individual |
| Full Name | BRADLEY G. WISE |
| Credential | LICDC-CS |
| Practice Address |
1150 N Main St Mansfield OH 44903-9718 |
| Mailing Address |
Po Box 788 Mansfield OH 44901-0788 |
| Practice Telephone | 4195262000 |
| Practice Fax Number | 4195248022 |
| Mailing Telephone | 4195262000 |
| Mailing Fax Number | 4195248022 |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2014-06-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
954172 | OH | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679060818 | Bradley William Wise | Student in an Organized Health Care Education/Training Program | 10099 Ridgegate Pkwy Ste 200, Lone Tree, CO 80124-5532 | 2018-04-13 |
| Street Address |
1150 N MAIN ST |
| City | MANSFIELD |
| State | OH |
| Zip Code | 44903-9718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598244642 | Tina Louise Heindel | Counselor | 1150 N Main St, Mansfield, OH 44903-9718 | 2018-08-09 |
| 1831693712 | Nicholas William Reichert | Social Worker | 1150 N Main St, Mansfield, OH 44903-9718 | 2018-03-23 |
| 1255876371 | Harout Michael Tabrizi | Counselor | 1150 N Main St, Mansfield, OH 44903-9718 | 2016-12-28 |
| 1588033260 | Lauren Garwood | Counselor | 1150 N Main St, Mansfield, OH 44903-9718 | 2015-09-23 |
| 1437491537 | Ronald Jakob Baumann | Dentist | 1150 N Main St, Mansfield, OH 44903-9718 | 2013-03-27 |
| 1184978470 | Julio Cesar Airaldi | Internal Medicine | 1150 N Main St, Mansfield, OH 44903-9718 | 2012-11-08 |
| 1023197787 | Ellen F. Stark | Psychologist | 1150 N Main St, Mansfield, OH 44903-9718 | 2006-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710495304 | Meredith Remy | Specialist/Technologist | 864 St. Rt. 314 S, Mansfield, OH 44903 | 2018-01-17 |
| 1639695174 | Judd Mateo | Home Health Aide | 1027 Neil Circle N., Mansfield, OH 44903 | 2017-08-16 |
| 1942722517 | Leighana Nichole Smith | Licensed Practical Nurse | 1451 Lucas Rd., Mansfield, OH 44903 | 2017-07-14 |
| 1528481710 | Sarah Elizabeth Hoffman | Occupational Therapy Assistant | 1600 Crider Rd., Mansfield, OH 44903 | 2014-01-24 |
| 1881025195 | Erica Renee Hanley | Occupational Therapy Assistant | 1600 Crider Road, Mansfield, OH 44903 | 2013-12-12 |
| 1164768917 | Colette Elaine Germann | Licensed Practical Nurse | 695 Satinwood N Cr, Mansfield, OH 44903 | 2012-12-26 |
| 1386996577 | Nicky Lynn Cole | Home Health Aide | 135 Columbia Avenue, Mansfield, OH 44903 | 2012-10-11 |
| 1215217989 | Darein Lee Wilson | Nurse's Aide | 175 Colonial Drive, Mansfield, OH 44903 | 2011-08-25 |
| 1205070802 | Simone Nannette Robinson | Licensed Practical Nurse | 576 Garfield Place, Mansfield, OH 44903 | 2009-04-27 |
| 1659518991 | Amelia Faye Johnson Grund | Nurse Practitioner | 336 Glessner Ave, Mob 2nd Fl, Mansfield, OH 44903 | 2009-01-08 |
| Find all providers in zip 44903 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548891989 | Soulace Group LLC | Counselor | 91 Park Ave W Ste A, Mansfield, OH 44902-1630 | 2020-02-03 |
| 1639652423 | Richard Johnson | Counselor | 3203 Star Hill Rd, Mansfield, TX 76063-2375 | 2018-09-08 |
| 1720564768 | Kurt Billups | Counselor | 6970 Dick Price Rd, Mansfield, TX 76063-5288 | 2018-07-12 |
| 1487144952 | Kenneth Cornell Johnson Jr. | Counselor | 91 Park Ave W, Mansfield, OH 44902-1630 | 2018-05-10 |
| 1104323898 | Kristin Jones | Counselor | 680 Park Ave. West, Mansfield, OH 44906-4490 | 2018-04-09 |
| 1912403130 | Scott Haverd Hudnall | Counselor | 608 Park Ave W, Mansfield, OH 44906-3769 | 2018-04-05 |
| 1609387786 | Thomas W Schluter Jr. | Counselor | 780 Park Ave W Ste D, Mansfield, OH 44906-3009 | 2017-10-17 |
| 1720518319 | Stephen Anderson | Counselor | 680 Park Ave W., Mansfield, OH 44906 | 2017-06-15 |
| 1235680075 | Sarah Hurst-pelfrey | Counselor | 680 Park Avenue West, Mansfield, OH 44906-2641 | 2016-10-17 |
| 1013397595 | Wesley Kyser | Counselor | 2 Smith Ave, Mansfield, OH 44905-2855 | 2015-06-01 |
| Find all providers in MANSFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.