Healthcare Provider Details

I. General information

NPI: 1053900605
Provider Name (Legal Business Name): HARRY WHEELER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2021
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 22ND ST
ASHLAND KY
41101-7803
US

IV. Provider business mailing address

PO BOX 790
ASHLAND KY
41105-0790
US

V. Phone/Fax

Practice location:
  • Phone: 160-632-9858
  • Fax:
Mailing address:
  • Phone: 606-329-8588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number309351
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number299668
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: