Donald Lester Wilson Jr., PHD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

20041034A Issued in IN

Practice address

2121 Lake Ave
VA Nihcs
Fort Wayne, IN 46805-5100

Phone

(260) 426-5431

Fax

(260) 460-1481

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154429348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 WEST SUPERIOR STREET",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021017",
            "telephone_number": "260-615-1173",
            "fax_number": "260-460-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 LAKE AVE",
            "address_2": "VA NIHCS",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055100",
            "telephone_number": "260-426-5431",
            "fax_number": "260-460-1481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DONALD",
        "middle_name": "LESTER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IN",
            "license": "20041034A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsey Wilson
• Christina Marie Wilson, FNP-C
• Craig Wilson
• Danielle Wilson
• David Allen Vernon Wilson, M.A.
• Emily Inez Wilson, PT
• Jaylen Marie Wilson
• Jennifer Wilson, CCC-SLP
• Jennifer Lynn Wilson
• Karmen Wilson, NP

• Counseling Psychologist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Counseling Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.