Individual provider Active NPI

Danice Wilson, PRACTITIONER, MED

  • Community/Behavioral Health Agency
  • Austell, GA
National Provider Identifier
1215339015
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Practice address
3961 Floyd Rd
Suite 300158
Austell, GA 30106-8535
Phone
(678) 785-7284
Fax
(770) 438-7929
NPI assigned
Sep 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X GA
Community/Behavioral Health Agency 251S00000X MD Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X GA
Community/Behavioral Health Agency 251S00000X GA
Adolescent and Children Mental Health Clinic/Center 261QM0855X MD
Mental Health Counselor 101YM0800X MD
Pastoral Counselor 101YP1600X
Pastoral Counselor 101YP1600X GA

Addresses

Primary practice location

3961 Floyd Rd
Suite 300158
Austell, GA 30106-8535

Mailing address

9814 Spinnaker St
Cheltenham, MD 20623-1350
Phone (833) 551-7284

Other practice location 1

9814 Spinnaker St
Cheltenham, MD 20623-1350
Phone (833) 551-7284

Other names 1

  • Danice Wilson-Bates Other name

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 Education

Practice roles

OrganizationSpecialtyStatusNew patients
Cobb County C.U.T.I.E.S, Inc. Community/Behavioral Health Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1215339015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9814 SPINNAKER ST",
            "city": "CHELTENHAM",
            "state": "MD",
            "postal_code": "206231350",
            "telephone_number": "833-551-7284",
            "fax_number": "240-681-3877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3961 FLOYD RD",
            "address_2": "SUITE 300158",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068535",
            "telephone_number": "678-785-7284",
            "fax_number": "770-438-7929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9814 Spinnaker St",
            "address_purpose": "LOCATION",
            "city": "Cheltenham",
            "state": "MD",
            "postal_code": "206231350",
            "country_code": "US",
            "telephone_number": "833-551-7284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DANICE",
        "credential": "PRACTITIONER, MED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANICE",
            "last_name": "WILSON-BATES",
            "credential": "CLINICIAN, MAED",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; 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.