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1629720099

NPI Code Detail

MEDICARE: BREYANA J WHEELER PLPX

MEDICARE: BREYANA J WHEELER PLPX

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	101Y00000X	Counselor	PLC8933	LA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	PLC8933	LA
3	101YM0800X	Mental Health Counselor	PLC8933	LA
4	171M00000X	Case Manager/Care Coordinator	PLC8933	LA

General Provider Information

NPI Number	:	1629720099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BREYANA J WHEELER PLPX

Provider Business Mailing Address
First Line	:	8416 CUMBERLAND PL
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-6543
Country	:	US
Telephone Number	:	225-408-6060
Fax Number	:	225-408-7410

Provider Business Practice Location Address
First Line	:	8416 CUMBERLAND PL
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-6543
Country	:	US
Telephone Number	:	225-408-6060
Fax Number	:	225-408-7410

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

Provider Enumeration Date	:	01/26/2022
Last Update Date	:	01/26/2022

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Directions to “ BREYANA J WHEELER PLPX” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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