Catherine Wilson

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-12-10164 Issued in FL

Practice address

7341 Office Park PL Ste 107
Melbourne, FL 32940-8280

Phone

(321) 759-6767

NPI assigned

Jun 14, 2012

Last updated

Nov 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Catherine Carroll Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Imagination Station ABA

  • Behavior Analyst
  • Melbourne, FL
  • NPI 1851165989
  NPD Authorized official

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1225390263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 STARLING WAY",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329556347",
            "telephone_number": "321-543-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7341 OFFICE PARK PL STE 107",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408280",
            "telephone_number": "321-759-6767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 Starling Way",
            "address_purpose": "LOCATION",
            "city": "Viera",
            "state": "FL",
            "postal_code": "329556347",
            "country_code": "US",
            "telephone_number": "321-759-6767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CATHERINE",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-12-10164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "CARROLL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tracy Wills, LMHC
• Adma Wilson-Romans, ARNP
• Ariel Michelle Wilson-Williams, LMHC
• Alexandra Wilson
• Brooke A Wilson, M.A. CFY-SLP
• Jessica Ann Ortega Wilson, DPM
• Joseph Wilson
• Lisett Irina Wilson
• Nicholas Wilson, LCSW
• Richard C Wilson, DPM

• Behavior Analyst in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.