Shyeasha Tanika Wilson, APRN-BC, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

23783 Issued in SC

Practice address

1911 Gadsden St Ste 204
Columbia, SC 29201-6400

Phone

(803) 254-9767

NPI assigned

Jul 26, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Shy Wilson Professional name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ms_swils298@landmarkhealth-direct.org

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.

• Charleston Counseling Center PC

  • Mental Health Counselor
  • Mount Pleasant, SC
  • NPI 1316375678

  Single Specialty

  Medicare reassignment NPD
• Dena McKeown

  • Clinical Child & Adolescent Psychologist
  • Columbia, SC
  • NPI 1770782799

  Single Specialty

  NPD (past)
• Myrtle Beach Counseling Center

  • Mental Health Counselor
  • Myrtle Beach, SC
  • NPI 1235784661

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1073167185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 GADSDEN ST STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292016400",
            "telephone_number": "803-254-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 GADSDEN ST STE 204",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292016400",
            "telephone_number": "803-254-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHYEASHA",
        "middle_name": "TANIKA",
        "name_prefix": "Miss",
        "credential": "APRN-BC, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-26",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "SC",
            "license": "104416",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "23783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHY",
            "last_name": "WILSON",
            "credential": "APRN-BC, PMHNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sarah Elizabeth Wilson, PNP
• Sarah Pamela Wilson, LPC, NCC, MAC
• Shalonda Rachelle Wilson
• Shane Michael Wilson
• Shanika Lavi Wilson, DSW, LCAS, LCSW
• Tanieka Ta'Sha Wilson
• Tanya Tanika Wilson, M.A., CCC-SLP
• Teresa Wilson
• Thomsd Lamar Wilson
• Twila Wilson

• Psychiatric/Mental Health Nurse Practitioner in Columbia, SC
• Providers in Columbia, SC by specialty
• Psychiatric/Mental Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; 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.