Active NPI
Debbie Ann Wilson, ICADC, CCS-DP-S
- Addiction (Substance Use Disorder) Counselor
- Flint, MI
National Provider Identifier
1144499575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1-04055
- Practice address
- 2091 Professional Dr
Flint, MI 48532-3657 - Phone
- (810) 732-1652
- Fax
- (810) 732-1735
- NPI assigned
- Feb 29, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1-04055 | MI | Primary |
Addresses
Primary practice location
2091 Professional Dr
Flint, MI 48532-3657
Mailing address
2091 Professional Dr
Flint, MI 48532-3657
Phone (810) 732-1652
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7509109640 | Other | MI | BCBS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-04055 | MI | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485820800000",
"number": "1144499575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2091 PROFESSIONAL DR",
"city": "FLINT",
"state": "MI",
"postal_code": "485323657",
"telephone_number": "810-732-1652",
"fax_number": "810-732-1735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2091 PROFESSIONAL DR",
"city": "FLINT",
"state": "MI",
"postal_code": "485323657",
"telephone_number": "810-732-1652",
"fax_number": "810-732-1735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "DEBBIE",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "ICADC, CCS-DP-S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-29",
"last_updated": "2017-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MI",
"license": "1-04055",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "7509109640",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.