Ariel Divinity Wilcoxen, M.S

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

15136 Issued in CA

Practice address

10776 Fremont St
Yucaipa, CA 92399-9630

Phone

(909) 797-0114

NPI assigned

Dec 20, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

State licenses

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.

• Forward Wellness Family Therapy, Inc.

  • Community/Behavioral Health Agency
  • Placentia, CA
  • NPI 1093398059
  Medicare reassignment NPD
• Family Service Agency of Fontana

  • Community/Behavioral Health Agency
  • San Bernardino, CA
  • NPI 1194971820
  NPD (past)
• Family Service Agency of San Bernardino

  • Community/Behavioral Health Agency
  • San Bernardino, CA
  • NPI 1437313624
  NPD (past)
• Trinity Youth Services

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Yucaipa, CA
  • NPI 1861848525
  NPD (past)

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

{
    "created_epoch": "1482192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1013452440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10776 FREMONT ST, YUCAIPA, CA, 92399",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "92399",
            "telephone_number": "909-797-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10776 FREMONT ST",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923999630",
            "telephone_number": "909-797-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOXEN",
        "first_name": "ARIEL",
        "middle_name": "DIVINITY",
        "name_prefix": "Miss",
        "credential": "M.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-20",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "15136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Carissa Yvonne Whitten
• Margaret Nell Wild, PH.D., M.S., MFTI
• Wildbloom Therapy
• Jessica Lynn Willemse, NP-C
• Gwenique Williams
• Mattison Williams, HIGH SCHOOL DIPLOMA

• Mental Health Counselor in Yucaipa, CA
• Providers in Yucaipa, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.