Mercedes Nicole Wilson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

11566 Issued in OK

Practice address

10830 E 45TH St # C102
Tulsa, OK 74146-3805

Phone

(539) 242-4100

Fax

(539) 242-4111

NPI assigned

Jun 13, 2025

Last updated

Jun 13, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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 OK

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

Mental Health Counselor

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mind Renewal Counseling Services LLC

  • Professional Counselor
  • Tulsa, OK
  • NPI 1265291876
  Medicare reassignment NPD

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

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1134015530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10830 E 45TH ST # C102",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741463805",
            "telephone_number": "539-242-4100",
            "fax_number": "539-242-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10830 E 45TH ST # C102",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741463805",
            "telephone_number": "539-242-4100",
            "fax_number": "539-242-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MERCEDES",
        "middle_name": "NICOLE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-13",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "11566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Stephen Wilson II, M.D.
• Marquita Renee Wilson
• McKenna Wilson
• Megan Wilson
• Melissa Anne Wilson, ARNP
• Michael Andrew Wilson Jr.
• Mikeya Wilson
• Nancy Wilson
• Naphisha Wilson
• Natalya Lashay Wilson

• Professional Counselor in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.