Jackie Wise, MHS

Counselor, Mental Health in Reading, PA. Individual provider (NPI-1).

NPI number1063007201

StatusActive

Last updated in NPPESMar 9, 2021

Details

NPI: 1063007201
Entity type: Individual (NPI-1)
Name: Jackie Wise
Credential: MHS
Sex: Male
Sole proprietor: Yes
Enumeration date: Mar 9, 2021
Certification date: Mar 9, 2021
Last updated: Mar 9, 2021

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
101YM0800X	Counselor, Mental Health	–	–	Yes

Practice location

3605 Orchard View Rd
Reading, PA 19606-3921

Phone 610-781-0331

Mailing address

3605 Orchard View Rd
Reading, PA 19606-3921

Phone 610-781-0331

Other practice locations

340 S Liberty St
Orwigsburg, PA 17961-2110

Phone 570-366-1154

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