Individual provider Active NPI

Amy E Wilkinson, M.ED., LPC

  • Professional Counselor
  • Ocean Springs, MS
National Provider Identifier
1235256306
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0861 Issued in MS
Practice address
2112 Bienville Blvd Ste K
Ocean Springs, MS 39564-3067
Phone
(228) 819-2171
Fax
(228) 205-4986
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0861 MS Primary

Addresses

Primary practice location

2112 Bienville Blvd Ste K
Ocean Springs, MS 39564-3067

Mailing address

2112 Bienville Blvd Ste K
Ocean Springs, MS 39564-3067
Phone (228) 819-2171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240111003530 MS Practitioner - Mental Health Counselor 6204287444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Behavioral Health Center PLLCGroup PAC ID 6204261985, 3 clinicians

Practice addresses (Care Compare)

2112 Bienville Blvd
Suite K
Ocean Springs, MS 39564-3067
Phone (228) 819-2171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
0861MSMDProfessional Counselor

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1235256306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 BIENVILLE BLVD STE K",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643067",
            "telephone_number": "228-819-2171",
            "fax_number": "228-205-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 BIENVILLE BLVD STE K",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643067",
            "telephone_number": "228-819-2171",
            "fax_number": "228-205-4986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "AMY",
        "middle_name": "E",
        "credential": "M.ED., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "0861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Springs, MS

Sources for this page

Verify at the official NPI Registry.