BRENDA GAIL WISE LPC
NPI 1558994483
Counselor in Shermans Dale, PA
About Brenda Gail Wise Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BRENDA GAIL WISE LPC (NPI 1558994483) is an individual counselor in Shermans Dale, Pennsylvania, licensed in Pennsylvania (PC007958) and active in the NPI registry since February 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Brenda Gail Wise Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Brenda Wise reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Worcester, MA 01604
- Reassigned Medicare billing, Pennsylvania enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Brenda Wise's NPI number?
The NPI number for Brenda Wise is 1558994483. It was assigned to this individual provider in the NPPES registry on February 19, 2020.
Where is Brenda Wise located?
Brenda Wise practices at 355 Burn Hill Rd, Shermans Dale, PA 17090. The listed phone number is (315) 286-6569.
What is Brenda Wise's specialty?
The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.
Is Brenda Wise enrolled in Medicare?
Yes. Brenda Wise is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Brenda Wise's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Brenda Wise reassigns Medicare benefits to Integrated Wellness Management Inc (Worcester, MA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Brenda Wise's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Brenda Wise was last updated on February 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Brenda Gail Wise, LPC · NPI 1558994483
Counselor provider in Shermans Dale, Pennsylvania. Individual provider, active in the CMS NPPES registry since February 19, 2020.
## Identity
- **NPI:** 1558994483 (Entity type: Individual)
- **Enumerated:** February 19, 2020
- **Primary specialty:** Counselor · taxonomy 101Y00000X
- **State license:** PC007958 (Pennsylvania)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 355 BURN HILL RD, Shermans Dale, PA 17090-8905
- **Phone:** (315) 286-6569
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Integrated Wellness Management Inc (NPI 1508214545, Worcester, MA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** February 23, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1558994483) · Data from the CMS NPPES public registry.