Individual provider Active NPI

Paula Wilson-Howell, PSY.D; LAC

  • Counseling Psychologist
  • Maplewood, NJ
National Provider Identifier
1174044168
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
37AC00367900 Issued in NJ
Practice address
2130 Millburn Ave Ste D2
Maplewood, NJ 07040-3749
Phone
(917) 771-6172
NPI assigned
Jun 29, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 37AC00367900 NJ Primary

Addresses

Primary practice location

2130 Millburn Ave Ste D2
Maplewood, NJ 07040-3749

Mailing address

1082 Shadowlawn Dr
Green Brook, NJ 08812-1747
Phone (917) 771-6172

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

State licenses

LicenseStateTypeSpecialty
37AC00367900NJMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Evolution Mind, LLC Current Accepting new patients

Locations

2130 Millburn Ave
Ste D2
Maplewood, NJ 07040
Phone (908) 265-9828

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174044168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1082 SHADOWLAWN DR",
            "city": "GREEN BROOK",
            "state": "NJ",
            "postal_code": "088121747",
            "telephone_number": "917-771-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 MILLBURN AVE STE D2",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403749",
            "telephone_number": "917-771-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON-HOWELL",
        "first_name": "PAULA",
        "credential": "PSY.D; LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NJ",
            "license": "37AC00367900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.