Organization Active NPI

Clayton Wilson PLLC

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1114769403
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CLAYTON WILSON PLLC
Practice address
2701 N Mildred Ave Apt 3a
Chicago, IL 60614-1407
Phone
(734) 395-3298
NPI assigned
Jun 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Authorized official

Name
Clayton Wilson, LCSWNPI 1891403408
Title
Sole Member
Phone
(734) 395-3298

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

2701 N Mildred Ave Apt 3a
Chicago, IL 60614-1407

Mailing address

2701 N Mildred Ave Apt 3a
Chicago, IL 60614-1407

Other practice location 1

2835 N Sheffield Ave Ste 302
Chicago, IL 60657-5084
Phone (872) 254-4563

National Provider Directory

National Provider Directory

Locations

2835 N Sheffield Ave
Ste 302
Chicago, IL 60657
Phone (773) 880-2214

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742256000000",
    "number": "1114769403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 N MILDRED AVE APT 3A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 N MILDRED AVE APT 3A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141407",
            "telephone_number": "734-395-3298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2835 N Sheffield Ave Ste 302",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575084",
            "country_code": "US",
            "telephone_number": "872-254-4563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLAYTON WILSON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-10",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "734-395-3298",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.