Autumn Lynne Wilson, MA, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5036 Issued in MN

Practice address

1884 Mahogany St
Mora, MN 55051-7111

Phone

(320) 339-9963

NPI assigned

Jun 9, 2025

Last updated

Jun 9, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wilson Ridge LLC

  • Mental Health Counselor
  • Mora, MN
  • NPI 1427913649
  NPD Authorized official
• Manes for Change LLC

  • Professional Counselor
  • Mora, MN
  • NPI 1336721364
  NPD

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1053206490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7145 375TH AVE NW",
            "city": "DALBO",
            "state": "MN",
            "postal_code": "550178403",
            "telephone_number": "763-567-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1884 MAHOGANY ST",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550517111",
            "telephone_number": "320-339-9963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AUTUMN",
        "middle_name": "LYNNE",
        "credential": "MA, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "5036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wikelius Counseling & Supervision, Inc. (Ampersand Psychological Services)
• Darci Jean Wikelius, PSY.D., LP
• Larissa N Wilhelm, DC
• James Matthew Williams, DDS
• Wilson Ridge LLC
• Robert M Woods
• Debra Wright
• Timothy Yeh, MD
• Juris Andris Zelenko, DPT
• Andrew Zych

• Mental Health Counselor in Mora, MN
• Providers in Mora, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.