Kaitlyn Wilson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.016326 Issued in IL

Practice address

100 N Main St Ste 12
Edwardsville, IL 62025-1981

Phone

(618) 513-9744

NPI assigned

Jun 13, 2022

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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 and National Provider Directory roles.

• Wilson Standard Wellness

  • Professional Counselor
  • Edwardsville, IL
  • NPI 1104776376
  NPD Authorized official

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1245960343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N MAIN ST STE 12",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MAIN ST STE 12",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251981",
            "telephone_number": "618-513-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KAITLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.016326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "talleystherapy@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 N Main St Ste 12",
            "city": "Edwardsville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620251981",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kaitlyn@wilsonstandardwellness.com",
            "affiliation": "N",
            "address_1": "100 N Main St Ste 12",
            "city": "Edwardsville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620251981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charles Williams, DMD
• Dylan Stephan Williams, RN
• Kirstie Ali Williams
• Wilson Standard Wellness
• Destiney Wilson
• Avonna K Wise, RN
• Witt and Wisdom Counseling PLLC
• Michelle R. Witt, LCSW
• Rachel Witt
• Brent Douglas Wohlford, D.M.D.

• Professional Counselor in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.