Active NPI
Kevin Sean Wilbanks, M.A.
- Professional Counselor
- Springfield, OR
National Provider Identifier
1194894485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C8383
- Practice address
- 98 U St
Springfield, OR 97477-2154 - Phone
- (470) 889-9360
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 003349 | GA | |
| Professional Counselor | 101YP2500X | 1396-4079-6004 | UT | |
| Professional Counselor | 101YP2500X | 7888 | ID | |
| Professional Counselor | 101YP2500X | C8383 | OR | Primary |
Addresses
Primary practice location
98 U St
Springfield, OR 97477-2154
Mailing address
98 U St
Springfield, OR 97477-2154
Phone (470) 889-9360
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 219822157 | Other | GA | UNITED BEH. HEALTH |
| 23652616 | Other | GA | AETNA |
| C410947618 | Other | GA | CELTIC INSURANCE |
| 236474735A | Medicaid | GA | |
| 506632 | Other | GA | VALUE OPTIONS |
| 10041237 | Medicaid | GA | |
| 280332000 | Medicaid | GA | |
| 280332000 | Other | GA | MAGELLAN B.H. |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7888 | ID | MD | Professional Counselor |
| C8383 | OR | MD | Professional Counselor |
| 1396-4079-6004 | UT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727827200000",
"number": "1194894485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "98 U ST",
"city": "SPRINGFIELD",
"state": "OR",
"postal_code": "974772154",
"telephone_number": "470-889-9360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "98 U ST",
"city": "SPRINGFIELD",
"state": "OR",
"postal_code": "974772154",
"telephone_number": "470-889-9360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILBANKS",
"first_name": "KEVIN",
"middle_name": "SEAN",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2024-10-02",
"certification_date": "2024-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "003349",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "UT",
"license": "1396-4079-6004",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "7888",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C8383",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEH. HEALTH",
"identifier": "219822157",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "23652616",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CELTIC INSURANCE",
"identifier": "C410947618",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "236474735A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "506632",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10041237",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "280332000",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN B.H.",
"identifier": "280332000",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.