Active NPI
Sandra Wilson Wilbourne, MS, LPCA
- Professional Counselor
- Roxboro, NC
National Provider Identifier
1124312913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A8842
- Practice address
- 20 Court St
Roxboro, NC 27573-5202 - Phone
- (919) 339-1585
- Fax
- (434) 374-5396
- NPI assigned
- Jun 8, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | A8842 | NC | Primary |
Addresses
Primary practice location
20 Court St
Roxboro, NC 27573-5202
Mailing address
2182 Wilbourne Rd
Skipwith, VA 23968-2218
Phone (434) 374-5396
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A8842 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342569600000",
"number": "1124312913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2182 WILBOURNE RD",
"city": "SKIPWITH",
"state": "VA",
"postal_code": "239682218",
"telephone_number": "434-374-5396",
"fax_number": "434-374-5396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 COURT ST",
"city": "ROXBORO",
"state": "NC",
"postal_code": "275735202",
"telephone_number": "919-339-1585",
"fax_number": "434-374-5396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILBOURNE",
"first_name": "SANDRA",
"middle_name": "WILSON",
"credential": "MS, LPCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-08",
"last_updated": "2012-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A8842",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roxboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.