Domonique S Wilson, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP029678 Issued in PA

Practice address

3000 Park Place Dr Ste 108
Washington, PA 15301-2068

Phone

(724) 374-3468

Fax

(724) 258-8914

NPI assigned

Nov 20, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, PA2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vital Healthcare SolutionsGroup PAC ID 3274830336, 107 clinicians

Silver Willow Wellness PCGroup PAC ID 5597271577, 118 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Silver Willow Wellness PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Reading, PA
  • NPI 1659164697

  PA

  Medicare reassignment Care Compare group
• Vital Healthcare Solutions

  • Psychiatry Physician
  • Sinking Springs, PA
  • NPI 1659736957

  PA

  Medicare reassignment Care Compare group
• Delaware County Professional Services, Inc

  • Psychiatry Physician
  • Media, PA
  • NPI 1952485864

  PA

  Medicare reassignment NPD
• Cope Treatment Centers in

  • Psychiatry Physician
  • East Liverpool, OH
  • NPI 1417022682

  OH

  Medicare reassignment NPD
• New Directions Mental Health, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • MC Murray, PA
  • NPI 1215904800
  NPD
• Intercare Health Systems, LTD, Dba Intercare Psychiatric Services

  • Psychiatry Physician
  • Pittsburgh, PA
  • NPI 1912094160

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1124893151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N CRAIG ST STE B",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152131569",
            "telephone_number": "610-892-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 PARK PLACE DR STE 108",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153012068",
            "telephone_number": "724-374-3468",
            "fax_number": "724-258-8914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15613 Pineview Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "East Liverpool",
            "state": "OH",
            "postal_code": "439209096",
            "country_code": "US",
            "telephone_number": "330-932-1594",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "230 N Craig St Ste B",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152131569",
            "country_code": "US",
            "telephone_number": "610-892-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DOMONIQUE",
        "middle_name": "S",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-20",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRNCNP0035421",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP029678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah A Wilkerson, CRNA
• Lauren Williams, M.S. CCC-SLP
• Michelle Achenne Williams, MSW, LSW
• Taylor Michelle Williams, MD
• Alissa Cowden Wilmot, M.D.
• Julie B Wilson
• Peter W Wilson, PA-C
• Steven Wilson, RPH
• Tiara Wilson, LPC
• Wimert Home I

• All providers in Washington, PA
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; 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.