Charla Ann Wilson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2269 Issued in MS

Practice address

2352 E Pass Rd
Gulfport, MS 39507-3805

Phone

(228) 284-2337

Fax

(228) 284-2337

NPI assigned

Apr 13, 2018

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1174010292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14605 RIVER PLANTATION CT",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395327617",
            "telephone_number": "228-229-7147",
            "fax_number": "228-392-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2352 E PASS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073805",
            "telephone_number": "228-284-2337",
            "fax_number": "228-284-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHARLA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-13",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "2269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan Scott Williamson
• Victoria Williford, P-LPC
• Valinda Willingham, M.S.,CCC-SLP
• Paul M Williston, O.C.
• Eric L Wills, LCSW
• David Charles Wilson, LMFT
• David John Wilson, MS,LPC
• Grant Christopher Wilson, DO
• Kristine D Wilson, LPC
• Tiyahri Cheriece Wilson, M.S.

• Mental Health Counselor in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.