Takisha Wilson, LGPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC16674 Issued in MD

Practice address

2714 Princess Victoria Way
Bowie, MD 20721-2439

Phone

(201) 341-0153

NPI assigned

Oct 20, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Purposed Life Therapy LLC

  • Mental Health Counselor
  • Lanham, MD
  • NPI 1154288306
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1003579764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2714 PRINCESS VICTORIA WAY",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207212439",
            "telephone_number": "201-341-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2714 PRINCESS VICTORIA WAY",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207212439",
            "telephone_number": "201-341-0153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TAKISHA",
        "credential": "LGPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-20",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC16674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisheba Vivianna Wilson
• Faith Wilson
• Monifa H. Wilson, MSW, LCSW
• Sheri Ann Wilson, PH.D.
• Susan Wilson
• Robert Joshua Wingfield, PHD
• Kenneth Wirlen, HHA
• Pamela Nchitu Wirlen
• Erica Wirmvem
• Wise and Wise, L.L.P.

• Mental Health Counselor in Bowie, MD
• Providers in Bowie, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.