Leslie Patrice Graham Wilson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00495300 Issued in NJ

Practice address

12 Audubon Ave Apt 205
Jersey City, NJ 07305-2222

Phone

(551) 697-0515

Fax

(201) 975-5726

NPI assigned

Jul 12, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Grow Healthcare Group of New Jersey PC

  • Mental Health Counselor
  • Hoboken, NJ
  • NPI 1841949328

  Professional

  Medicare reassignment NPD

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1174195903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 AUDUBON AVE APT 205",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073052222",
            "telephone_number": "551-697-0515",
            "fax_number": "201-975-5726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 AUDUBON AVE APT 205",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073052222",
            "telephone_number": "551-697-0515",
            "fax_number": "201-975-5726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM WILSON",
        "first_name": "LESLIE",
        "middle_name": "PATRICE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00495300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lesliepatrice@lpgwcounseling.hush.com",
            "affiliation": "N",
            "endpointDescription": "Business",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Written",
            "address_1": "12 Audubon Ave Apt 205",
            "city": "Jersey City",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "073052222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Gorin, RDN
• Vaishali Goswami
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• Gotham City Orthopedics, LLC
• Srikanth Goud Gouni, MD
• Vivian Graham, DDS
• Jennifer A Grajales, COTA
• Nelson P. Gramatica, APN-C
• Valentina Gran, CMT
• Mark Granata, DPM

• Professional Counselor in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.