Marlene Elizabeth Wilson, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

236775 Issued in AZ

Practice address

11022 S 51St St Ste 250
Phoenix, AZ 85044-4308

Phone

(480) 939-6137

Fax

(602) 429-8445

NPI assigned

Feb 8, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Mountain Family Psychiatry LLCGroup PAC ID 7012346760, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marlene.wilson.1@21710.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/21710/brand/1/csg/1/fhir/r4

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.

• South Mountain Family Psychiatry, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
  • NPI 1336788868
  Medicare reassignment Care Compare group NPD
• Resilient Health, Inc.

  dba Resilient Health

  • Community/Behavioral Health Agency
  • Gilbert, AZ
  • NPI 1255841995
  NPD (past)

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

{
    "created_epoch": "1360281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1205175304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11022 S 51ST ST STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444308",
            "telephone_number": "480-939-6137",
            "fax_number": "602-429-8445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11022 S 51ST ST STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444308",
            "telephone_number": "480-939-6137",
            "fax_number": "602-429-8445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARLENE",
        "middle_name": "ELIZABETH",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-08",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "236775",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN174104",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marlene.wilson.1@21710.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AthenaOne Direct Email Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11022 S 51st St Ste 250",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850444308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lindsay Joan Wilson, PT, DPT
• Linette Wilson
• Lorri Wilson, LMFT
• Malcolm Wilson
• Marin Delaney Wilson
• Michael Wilson
• Montana Ashley Wilson, APRN
• Morgan Wilson
• Natalie Lynn Wilson, MSN, APRN, BC, MPH
• Nyla Wilson, RBT

• Psychiatric/Mental Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; 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.