Ebony N Wilson, LPC, LADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4405 Issued in CT

Practice address

65 Highfield Dr
Torrington, CT 06790-5826

Phone

(860) 626-5002

NPI assigned

Sep 6, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

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.

• A Step Up Counseling LLC

  • Professional Counselor
  • Torrington, CT
  • NPI 1285142646

  Addiction (Substance Use Disorder)

  NPD (past) Authorized official

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1023536463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 HIGHFIELD DR",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067905826",
            "telephone_number": "860-626-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 HIGHFIELD DR",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067905826",
            "telephone_number": "860-626-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "EBONY",
        "middle_name": "N",
        "credential": "LPC, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "1267",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith Whiting
• Garrett Whittaker
• Lillian Wilbert
• Tracey Jeannette Wiles, DO
• Taylor Wilfore
• Jessica Lynne Wilson
• Darren Allen Winkler, DPM
• Deborah Winter
• Douglas C Wisch, MD
• Jeffrey Wojewoda, DMD

• Professional Counselor in Torrington, CT
• Providers in Torrington, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.