Active NPI
Crystal Wilson
- Professional Counselor
- Pearland, TX
National Provider Identifier
1174353528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 95586
- Practice address
- 2743 Smith Ranch Rd Unit 801
Pearland, TX 77584-5220 - Phone
- (210) 940-2502
- NPI assigned
- Aug 1, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 95586 | TX | Primary |
Addresses
Primary practice location
2743 Smith Ranch Rd Unit 801
Pearland, TX 77584-5220
Mailing address
1311 Owl Tree CT
Fresno, TX 77545-7595
Phone (281) 731-1409
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
| License | State | Type | Specialty |
|---|---|---|---|
| 95586 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722470400000",
"number": "1174353528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1311 OWL TREE CT",
"city": "FRESNO",
"state": "TX",
"postal_code": "775457595",
"telephone_number": "281-731-1409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2743 SMITH RANCH RD UNIT 801",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775845220",
"telephone_number": "210-940-2502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CRYSTAL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-01",
"last_updated": "2024-08-01",
"certification_date": "2024-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "95586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pearland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.