Provider Demographics
NPI:1235376732
Name:WHEELER, JAMIE MARIE (MS, REG MH INTERN)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:MARIE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:MS, REG MH INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9873 BAYWINDS DR
Mailing Address - Street 2:UNIT 5307
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1845
Mailing Address - Country:US
Mailing Address - Phone:561-267-9129
Mailing Address - Fax:
Practice Address - Street 1:1300 NW 17TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-2578
Practice Address - Country:US
Practice Address - Phone:561-267-9129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH6758101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist