Active NPI
Ryan Wilson, MS, LAC. NCC, CPRP
- Counselor
- East Brunswick, NJ
National Provider Identifier
1124592944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 37AC00398600
- Practice address
- 15 W Prospect St
East Brunswick, NJ 08816-2161 - Phone
- (732) 254-0600
- NPI assigned
- Jan 15, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 37AC00398600 | NJ | Primary |
Addresses
Primary practice location
15 W Prospect St
East Brunswick, NJ 08816-2161
Mailing address
6 Oakwood PL
Carteret, NJ 07008-1510
Phone (732) 713-6772
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 |
|---|---|---|---|
| 37AC00398600 | NJ | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547510400000",
"number": "1124592944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 OAKWOOD PL",
"city": "CARTERET",
"state": "NJ",
"postal_code": "070081510",
"telephone_number": "732-713-6772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 W PROSPECT ST",
"city": "EAST BRUNSWICK",
"state": "NJ",
"postal_code": "088162161",
"telephone_number": "732-254-0600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "RYAN",
"credential": "MS, LAC. NCC, CPRP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-15",
"last_updated": "2019-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NJ",
"license": "37AC00398600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Brunswick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.