Individual provider Active NPI

Andrea Bowen Wilkinson, ED.S.

  • Mental Health Counselor
  • Winter Garden, FL
National Provider Identifier
1225742786
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH23349 Issued in FL
Practice address
161 S Boyd St Ste 100
Winter Garden, FL 34787-3574
Phone
(912) 281-1946
NPI assigned
Jan 10, 2023
Last updated
Jan 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH23349 FL Primary

Addresses

Primary practice location

161 S Boyd St Ste 100
Winter Garden, FL 34787-3574

Mailing address

13512 Sunset Lakes Cir
Winter Garden, FL 34787-5416
Phone (912) 281-1946

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
IMH23349FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1225742786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13512 SUNSET LAKES CIR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875416",
            "telephone_number": "912-281-1946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 S BOYD ST STE 100",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873574",
            "telephone_number": "912-281-1946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "ANDREA",
        "middle_name": "BOWEN",
        "credential": "ED.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH23349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.