Lisa H Wilson, MS, SC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39002889A Issued in IN

Practice address

12337 Hancock St Ste 20
Carmel, IN 46032-5885

Phone

(317) 706-6744

Fax

(317) 706-6700

NPI assigned

Nov 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Baume Psychological Services, P.C.

  • Clinical Psychologist
  • Carmel, IN
  • NPI 1811246507
  Medicare reassignment NPD
• Emerald Neuro-Recover

  • Family Medicine Physician
  • Carmel, IN
  • NPI 1508334814
  NPD (past)
• Synergy Wellness Associates LLC

  • Mental Health Counselor
  • Carmel, IN
  • NPI 1467202572
  NPD (past)
• Connect the Dots Coordination, Inc.

  • Early Intervention Provider Agency
  • Canton, GA
  • NPI 1629255724
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1013096643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12337 HANCOCK ST STE 20",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325885",
            "telephone_number": "317-706-6744",
            "fax_number": "317-706-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12337 HANCOCK ST STE 20",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325885",
            "telephone_number": "317-706-6744",
            "fax_number": "317-706-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LISA",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "MS, SC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002889A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Diane Wilson, PMHCNS-BC
• Dawn Wilson
• Derron Wilson, MD
• Jody Renee Wilson, D.D.S
• Lisa Wilson
• Tania Lakelle Wilson
• Tara M Wilson, CFA
• Alayna A Wimmer, AUD
• Courtney Winbush, NP
• Daviana L Winfield

• Mental Health Counselor in Carmel, IN
• Providers in Carmel, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.