Stanley D Wilson, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY00000688 Issued in WA

Practice address

1814 105TH St SE
Suite 101
Everett, WA 98208-4816

Phone

(425) 385-8337

Fax

(425) 385-3748

NPI assigned

Mar 21, 2007

Sex

Male

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

Enrolled in WA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104942374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 105TH ST SE",
            "address_2": "SUITE 101",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084816",
            "telephone_number": "425-385-8337",
            "fax_number": "425-385-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 105TH ST SE",
            "address_2": "SUITE 101",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084816",
            "telephone_number": "425-385-8337",
            "fax_number": "425-385-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STANLEY",
        "middle_name": "D",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY00000688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Michele Wilson, M.A., CCC-SLP
• Lori Valentine Wilson, P.T.
• Meredith Ashlyn Wilson, M.A., CCC-SLP
• Sean Timothy Wilson, PHARM.D.
• Sharon J. Wilson, ARNP
• Susan Louise Wilson, CNM
• Tayler Wilson
• Whitney A Wilson, LMHC, CDP
• Susan J. Wiltse, LPN
• Karen Elaine Winchell, R.N., B.S.N.

• Psychologist in Everett, WA
• Providers in Everett, WA by specialty
• Psychologist in Washington

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.