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General NPI Number Information
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NPI Number | 1558735662
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Entity Type | Individual
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Provider Name | CHRISTINA WILEY MED LPC-S
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Gender | Female
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Dates
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Enumeration Date | 12/01/2015
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 4008 CALIFORNIA LN
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City | OAK RIDGE
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State | LA
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Zip | 71264-9331
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Country | US
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Telephone | 318-732-8023
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Fax | 318-605-4133
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Provider Business Mailing Address
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Address Line | 1117 MARION HWY
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City | FARMERVILLE
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State | LA
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Zip | 71241-9313
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Country | US
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Telephone | 318-503-8682
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Fax | 318-982-8103
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4851
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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