Kenyatta Wilson, M.S.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC007401 Issued in GA

Practice address

500 Old Bremen Rd
Suite 101
Carrollton, GA 30117-5216

Phone

(770) 820-3070

NPI assigned

Jan 28, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Kenyatta Wilson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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 Professional Counseling & Consulting, LLC

  • Professional Counselor
  • Carrollton, GA
  • NPI 1568873420
  NPD (past) Authorized official

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1275710667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 BANKHEAD HWY STE G",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301171970",
            "telephone_number": "770-820-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 OLD BREMEN RD",
            "address_2": "SUITE 101",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301175216",
            "telephone_number": "770-820-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KENYATTA",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007401",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC007401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENYATTA",
            "last_name": "WILSON",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Colby Jon Williamson, CRNA
• Deborah Susanne Willis, CSW007966
• Michael Andrew Wilshire, MD
• Wilson Professional Counseling & Consulting, LLC
• Britt Callahan Wilson, M.D.
• Samory Wilson, RN
• Tracy C Wilson, M.ED.
• Wesley E Wilvert, D.C.
• Tracey J Winter, DPT
• Wise Cracks Chiropractic

• Mental Health Counselor in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.