NPIMap

Organization Active NPI

Dwilson Counseling, PLLC

Doing business as Optimal Focus Counseling

  • Professional Counselor
  • O'Fallon, IL
National Provider Identifier
1053106633
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
DWILSON COUNSELING, PLLC
Doing business as
Optimal Focus Counseling
Practice address
640 Pierce Blvd Ste 200
O Fallon, IL 62269-2584
Phone
(618) 406-2490
NPI assigned
Apr 14, 2025
Last updated
Apr 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Authorized official

Name
Dominique WilsonNPI 1407345192
Title
Owner
Phone
(618) 406-2490

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary
Adult Mental Health Clinic/Center 261QM0850X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

640 Pierce Blvd Ste 200
O Fallon, IL 62269-2584

Mailing address

2126 Village Pkwy
San Antonio, TX 78251-2611
Phone (317) 900-6556

Other names 1

  • Optimal Focus Counseling Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dwilson Counseling PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1053106633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2126 VILLAGE PKWY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782512611",
            "telephone_number": "317-900-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 PIERCE BLVD STE 200",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692584",
            "telephone_number": "618-406-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DWILSON COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-13",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-406-2490"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optimal Focus Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in O'Fallon, IL

Sources for this page

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