Audrey Wilson, LCPC

Key facts

NPI

1083499255

Entity type

Organization (NPI type 2)

Primary specialty

Mental Health Counselor 101YM0800X

Legal business name

AUDREY WILSON, LCPC

Practice address

1 Merchants PLZ Ste 206
Oswego, IL 60543-9453

Phone

(630) 740-8922

NPI assigned

Aug 28, 2023

Organization subpart

No

Authorized official

Name

Audrey Wilson, LCPC, CADC, CTP NPI 1588129779

Title

Clinical Therapist

Phone

(630) 740-8922

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Audrey Wilson, LCPC, CADC, CTP Counselor · Naperville, IL · NPI 1588129779
  NPD Authorized official

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 28, 2023.

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1083499255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MERCHANTS PLZ STE 206",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605439453",
            "telephone_number": "630-740-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERCHANTS PLZ STE 206",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605439453",
            "telephone_number": "630-740-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUDREY WILSON, LCPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "630-740-8922",
        "authorized_official_credential": "LCPC, CADC, CTP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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