MEDICARE: NANCY C WILEY LICSW

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	118383	MA
2	1041C0700X	Clinical Social Worker	098836	NY

General Provider Information

NPI Number	:	1558407973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY C WILEY LICSW

Provider Business Mailing Address
First Line	:	236 SUNSET DR
Second Line	:
City	:	SOUTH NEW BERLIN
State	:	NY
Zip	:	13843-2278
Country	:	US
Telephone Number	:	774-269-5915
Fax Number	:	774-521-3791

Provider Business Practice Location Address
First Line	:	236 SUNSET DR
Second Line	:
City	:	SOUTH NEW BERLIN
State	:	NY
Zip	:	13843-2278
Country	:	US
Telephone Number	:	774-269-5915
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	11/22/2025

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Directions to “ NANCY C WILEY LICSW” Practice Location

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