Kisha Campbell-Wilson, MS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1611 Regal River Cir
Ocoee, FL 34761-5119

Phone

(407) 470-2307

NPI assigned

Jun 14, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1053041947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 REGAL RIVER CIR",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347615119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 REGAL RIVER CIR",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347615119",
            "telephone_number": "407-470-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL-WILSON",
        "first_name": "KISHA",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kisha.wilson@flsteps.org",
            "affiliation": "N",
            "endpointDescription": "kisha.wilson@flsteps.org",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1611 Regal River Cir",
            "city": "Ocoee",
            "state": "FL",
            "country_code": "US",
            "postal_code": "347615119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carmelo Calderone, M.D.
• Zoe Callahan, BSN, MSN, CPNP-PC
• Mary Michelle Cameron, PA-C
• Barbara Maria Camilotti, PT, PHD
• Leana Camodeca, NUTRITIONIST
• Brenda Campbell
• Terrieann Campbell
• Anastasia Campo, CCC-SLP
• Adeline Cardenas Diaz
• Fransheska M Cardona-Leon, LCSW

• Addiction (Substance Use Disorder) Counselor in Ocoee, FL
• Providers in Ocoee, FL by specialty
• Addiction (Substance Use Disorder) Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.