Active NPI
Douglas R Wilbur, MA, LPC-MHSP, NCC
- Professional Counselor
- Murfreesboro, TN
National Provider Identifier
1154037067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6104
- Practice address
- 1102 Dow St
Murfreesboro, TN 37130-2486 - Phone
- (615) 704-7170
- Fax
- (615) 904-7288
- NPI assigned
- Jan 24, 2023
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6104 | TN | Primary |
Addresses
Primary practice location
1102 Dow St
Murfreesboro, TN 37130-2486
Mailing address
2596 N Mount Juliet Rd
Mt Juliet, TN 37122-3170
Phone (615) 648-5199
Other practice location 1
2596 N Mount Juliet Rd
Mount Juliet, TN 37122-3170
Phone (615) 648-5199 ext. 3
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6104 | TN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674518400000",
"number": "1154037067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2596 N MOUNT JULIET RD",
"city": "MT JULIET",
"state": "TN",
"postal_code": "371223170",
"telephone_number": "615-648-5199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1102 DOW ST",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "371302486",
"telephone_number": "615-704-7170",
"fax_number": "615-904-7288"
}
],
"practiceLocations": [
{
"address_1": "2596 N Mount Juliet Rd",
"address_purpose": "LOCATION",
"city": "Mount Juliet",
"state": "TN",
"postal_code": "371223170",
"country_code": "US",
"telephone_number": "615-648-5199 x3",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILBUR",
"first_name": "DOUGLAS",
"middle_name": "R",
"credential": "MA, LPC-MHSP, NCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-01-24",
"last_updated": "2023-01-24",
"certification_date": "2023-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "6104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murfreesboro, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.