Individual provider Active NPI

Emily Elizabeth Wilson

  • Mental Health Counselor
  • Tuscaloosa, AL
National Provider Identifier
1184134165
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4142 Issued in AL
Practice address
201 Marina Dr Apt 1001
Tuscaloosa, AL 35406-3243
Phone
(419) 571-1727
NPI assigned
Oct 4, 2017
Last updated
Apr 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1700506 OH
Mental Health Counselor 101YM0800X 4142 AL Primary

Addresses

Primary practice location

201 Marina Dr Apt 1001
Tuscaloosa, AL 35406-3243

Mailing address

201 Marina Dr Apt 1001
Tuscaloosa, AL 35406-3243

Other practice location 1

3964 Hamilton Square Blvd
Groveport, OH 43125-9119
Phone (614) 610-1506 ext. 1814

Other identifiers 1

IdentifierTypeStateIssuer
1093251225OtherOHPRIVATE INSURANCE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wilson.2328@osu.edu

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
4142ALMDMental Health Counselor
1700506OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Emily Wilson Counseling LLC Mental Health CurrentSince Jan 21, 2022 Accepting new patients

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": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1184134165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MARINA DR APT 1001",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354063243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MARINA DR APT 1001",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354063243",
            "telephone_number": "419-571-1727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3964 Hamilton Square Blvd",
            "address_purpose": "LOCATION",
            "city": "Groveport",
            "state": "OH",
            "postal_code": "431259119",
            "country_code": "US",
            "telephone_number": "614-610-1506 x1814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "EMILY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "1700506",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "4142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INSURANCE",
            "identifier": "1093251225",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wilson.2328@osu.edu",
            "affiliation": "N",
            "address_1": "201 Marina Dr Apt 1001",
            "city": "Tuscaloosa",
            "state": "AL",
            "country_code": "US",
            "postal_code": "354063243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.