MEDICARE: KILER JONEE WILSON M.ED., LPC

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	101YM0800X	Mental Health Counselor	PC009731	PA

General Provider Information

NPI Number	:	1922520733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KILER JONEE WILSON M.ED., LPC

Provider Business Mailing Address
First Line	:	170 46TH ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15201-2943
Country	:	US
Telephone Number	:	412-720-1906
Fax Number	:

Provider Business Practice Location Address
First Line	:	1407 MOUNT ROYAL BLVD
Second Line	:
City	:	GLENSHAW
State	:	PA
Zip	:	15116-2205
Country	:	US
Telephone Number	:	412-455-6890
Fax Number	:

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

Provider Enumeration Date	:	07/13/2017
Last Update Date	:	12/01/2021

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