Angela Renee Wilson, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178011253 Issued in IL

Practice address

201 W Springfield Ave
Suite 1005
Champaign, IL 61820-6385

Phone

(217) 693-4913

NPI assigned

Sep 11, 2015

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

Not listed in the public Medicare enrollment file

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.

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• Catalyst Counseling Center LLC

  dba C3

  • Mental Health Counselor
  • Champaign, IL
  • NPI 1033770243
  NPD

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1144698838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 EDWARDS CT",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618562277",
            "telephone_number": "217-762-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W SPRINGFIELD AVE",
            "address_2": "SUITE 1005",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618206385",
            "telephone_number": "217-693-4913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ANGELA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-11",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178011253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Anne Willis
• Naomi Willis
• Willow Counseling LLC
• Wilma L. Bryant Psychotherapy LTD (Wilma L Bryant LCSW)
• Carol Wilson-Smith, L.C.S.W.
• Celina R Wilson
• Henry Eugene Wilson III, OTR/L
• Isaiah Wilson
• Jessica Wilson
• Kathryn A Wilson, MD

• Professional Counselor in Champaign, IL
• Providers in Champaign, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; 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.