BRUCE A WILBER JR. (NPI# 1003063157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003063157 |
| Entity Type | Individual |
| Full Name | BRUCE A WILBER JR. |
| Credential | SAC |
| Practice Address |
N2150 Kesaehkahtek Rd Gresham WI 54128-9602 |
| Practice Telephone | 7157993835 |
| Practice Fax Number | 7157993836 |
| Mailing Telephone | 7157993835 |
| Mailing Fax Number | 7157993836 |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2008-08-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
15433131 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 41162800 | 05 |
| Street Address |
N2150 KESAEHKAHTEK RD |
| City | GRESHAM |
| State | WI |
| Zip Code | 54128-9602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487829883 | Annette Pauline Latender | Counselor | N2150 Kesaehkahtek Rd, Gresham, WI 54128-9602 | 2008-04-25 |
| 1942708789 | Brandon Waupekenay | Counselor | N2150 Kesaehkahtek Rd, Gresham, WI 54128-9602 | 2018-01-26 |
| 1679071492 | Addie Mae Caldwell | Counselor | N2150 Kesaehkahtek Rd, Gresham, WI 54128-9602 | 2018-01-26 |
| 1962867085 | Natalie Cornelius | Counselor | N2150 Kesaehkahtek Rd, Gresham, WI 54128-9602 | 2015-12-16 |
| 1396124939 | Rachel A Seegers | Counselor | N2150 Kesaehkahtek Rd, Gresham, WI 54128-9602 | 2015-05-28 |
| 1760889471 | Jeniifer Metoxen | Counselor | N2150 Kesaehkahtek Rd, Gresham, WI 54128-9602 | 2014-11-24 |
| 1588829030 | Maehnowesekiyah Wellness Center | Community/Behavioral Health | N2150 Kesaehkahtek Rd, Gresham, WI 54128-9602 | 2008-07-24 |
| 1912162462 | Maehnowesekiyah Wellness Center | Community/Behavioral Health | N2150 Kesaehkahtek Rd, Gresham, WI 54128-9602 | 2008-07-24 |
| 1184889560 | Steven Dakai | Counselor | N2150 Kesaehkahtek Rd, Gresham, WI 54128-9602 | 2008-07-24 |
| 1497910103 | Maehnowesekiyah Wellness Center | Community/Behavioral Health | N2150 Kesaehkahtek Rd, Gresham, WI 54128-9602 | 2008-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447425145 | Mary Bernadette Barney | Counselor | N2150 Kesaehkahtek, Gresham, WI 54128 | 2008-04-24 |
| 1861853566 | Jennifer Lidbury | Registered Nurse | N2150 Kesaehkahtek, Gresham, WI 54128 | 2016-03-09 |
| 1427315944 | Brian A Krause | Occupational Therapy Assistant | W10877 Upper Red Lake Rd, Gresham, WI 54128-8995 | 2012-04-20 |
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336623602 | Vistas Counseling, LLC | Counselor | 406 Ne 4th St Ste 106, Gresham, OR 97030-7496 | 2018-09-21 |
| 1811476518 | Amanda Gene Evans Mahony | Counselor | 233 Sw Wallula Ave, Gresham, OR 97080-6858 | 2018-08-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1265735088 | Michael Arthur Rhys Pasimio | Counselor | 123 E Powell Blvd Ste 212, Gresham, OR 97030-7622 | 2010-12-16 |
| 1053636001 | Jamie Williams | Counselor | 25050 Se Stark St Ste 300, Gresham, OR 97030-3388 | 2010-04-01 |
| 1487829883 | Annette Pauline Latender | Counselor | N2150 Kesaehkahtek Rd, Gresham, WI 54128-9602 | 2008-04-25 |
| 1447425145 | Mary Bernadette Barney | Counselor | N2150 Kesaehkahtek, Gresham, WI 54128 | 2008-04-24 |
| 1851519128 | Miguel Tellez | Counselor | 775 Ne 9th St, Gresham, OR 97030-5668 | 2007-04-23 |
| 1619095338 | Emelie M Thompson | Counselor | 400 Ne 7th, Gresham, OR 97030 | 2007-03-27 |
| 1326153495 | Daniel Martin Dickinson | Counselor | 1550 Nw Eastman Pkwy Ste 100, Gresham, OR 97030-3830 | 2006-08-20 |
| Find all providers in GRESHAM | ||||
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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.