Active NPI
Carlita N Wilson, MSW
- Mental Health Counselor
- Detroit, MI
National Provider Identifier
1063514933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6801034657
- Practice address
- 20548 Fenkell St
Detroit, MI 48223-1613 - Phone
- (313) 255-3333
- Fax
- (313) 255-4335
- NPI assigned
- Sep 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6801034657 | MI | Primary |
Addresses
Primary practice location
20548 Fenkell St
Detroit, MI 48223-1613
Mailing address
20548 Fenkell St
Detroit, MI 48223-1613
Phone (313) 255-3333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801034657 | MI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063514933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20548 FENKELL ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482231613",
"telephone_number": "313-255-3333",
"fax_number": "313-255-4335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20548 FENKELL ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482231613",
"telephone_number": "313-255-3333",
"fax_number": "313-255-4335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CARLITA",
"middle_name": "N",
"name_prefix": "Ms.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6801034657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.