Wilson Wellness Center, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

WILSON WELLNESS CENTER, LLC

Practice address

6030 Marshalee Dr Ste M114
Elkridge, MD 21075-5987

Phone

(443) 591-0202

NPI assigned

Mar 19, 2024

Last updated

Mar 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Devetta Wilson, LCPCNPI 1033877618

Title

Owner, Mental Health Therapist

Phone

(202) 240-2994

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Devetta Shaunta Wilson, LCPC

  • Professional Counselor
  • Elkridge, MD
  • NPI 1033877618
  NPD Authorized official

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1235999244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6030 MARSHALEE DR STE M114",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210755987",
            "telephone_number": "443-591-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 MARSHALEE DR STE M114",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210755987",
            "telephone_number": "443-591-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DEVETTA",
        "authorized_official_title_or_position": "OWNER, MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "202-240-2994",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Washington, LMT
• Khiarra Watkins, PHARMD
• Beth Whiteford, CRNP
• William a Gormley, DPM, LLC
• Calista Williams, PHARM.D.
• Devetta Shaunta Wilson, LCPC
• Jill Holen Witkin, LMT
• Dina Wolfe, R.PH.
• Erica Wright
• Giavaun Marshay Young, LMSW

• Professional Counselor in Elkridge, MD
• Providers in Elkridge, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.