Individual provider Active NPI

Aimee Wilson, LMHC

  • Mental Health Counselor
  • Bartow, FL
National Provider Identifier
1104325364
Registry record updated Jul 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH16300 Issued in FL
Practice address
1860 E Gibbons St
Bartow, FL 33830-6711
Phone
(321) 300-4399
NPI assigned
Feb 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH14655 FL
Mental Health Counselor 101YM0800X MH16300 FL Primary

Addresses

Primary practice location

1860 E Gibbons St
Bartow, FL 33830-6711

Mailing address

1066 Blackwolf Run Rd
Champions Gate, FL 33896-7950
Phone (321) 697-6269

Other practice location 1

7512 Cypress Gardens Blvd
Winter Haven, FL 33884-3200
Phone (407) 977-4335

Other practice location 2

1975 S John Young Pkwy
Kissimmee, FL 34741-0603
Phone (321) 236-1540

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Aimee.wilson13@outlook.com

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

LicenseStateTypeSpecialty
IMH14655FLMDMental Health Counselor
MH16300FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627084800000",
    "number": "1104325364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1066 BLACKWOLF RUN RD",
            "city": "CHAMPIONS GATE",
            "state": "FL",
            "postal_code": "338967950",
            "telephone_number": "321-697-6269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 E GIBBONS ST",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338306711",
            "telephone_number": "321-300-4399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7512 Cypress Gardens Blvd",
            "address_purpose": "LOCATION",
            "city": "Winter Haven",
            "state": "FL",
            "postal_code": "338843200",
            "country_code": "US",
            "telephone_number": "407-977-4335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1975 S John Young Pkwy",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347410603",
            "country_code": "US",
            "telephone_number": "321-236-1540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AIMEE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-02",
        "last_updated": "2021-07-24",
        "certification_date": "2021-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH14655",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Aimee.wilson13@outlook.com",
            "affiliation": "N",
            "address_1": "1066 Blackwolf Run Rd",
            "city": "Champions Gate",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338967950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bartow, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2021; 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.