Shane Wilson, MS, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH20043 Issued in FL

Practice address

7777 SW 86 St BLDG F1
Apt 212
Miami, FL 33143

Phone

(786) 444-1735

NPI assigned

Dec 17, 2021

Last updated

Dec 17, 2021By the provider in NPPES

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

Other names 1

• Shane Wilson Professional name

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

Master of Science

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.

• De-Stressing Minds LLC

  • Mental Health Counselor
  • Doral, FL
  • NPI 1902534589
  NPD Authorized official

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1164182135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 SW 86 ST BLDG F1",
            "address_2": "APT 212",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33143",
            "telephone_number": "786-444-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 SW 86 ST BLDG F1",
            "address_2": "APT 212",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33143",
            "telephone_number": "786-444-1735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7777 SW 86 St BLDG F1",
            "address_2": "Apt 212",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "33143",
            "country_code": "US",
            "telephone_number": "786-444-1735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHANE",
        "credential": "MS, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-17",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH20043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANE",
            "last_name": "WILSON",
            "credential": "MS, LMHC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lilian Anet Wilson, ARNP
• Nicholene Wilson
• Presley Wilson
• Qi Wilson
• Samyra Wilson
• Tihesha L Wilson, MD
• Woodrow Wilson, PH.D.
• Mabel Wilt, MSN, APRN, FNP-C
• Hector Wiltz Jr, M.D
• Wiltz Medical Group Inc

• Mental Health Counselor in Miami, FL
• Providers in Miami, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.