MEDICARE: WISE COUNSEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1154003820
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WISE COUNSEL

Provider Business Mailing Address
First Line	:	1405 OLROYD DR
Second Line	:
City	:	SWANSEA
State	:	IL
Zip	:	62226-8565
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2055 CRAIGSHIRE RD STE 350D
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-4028
Country	:	US
Telephone Number	:	618-737-9634
Fax Number	:

Authorized Official
Title or Position	:	CO-FOUNDER
Name	:	CARMEL BROWN
Credential	:
Telephone Number	:	618-737-9634

Provider Enumeration Date	:	08/02/2023
Last Update Date	:	08/02/2023

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Directions to “WISE COUNSEL ” Practice Location

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