Active NPI
Samuel Beringer Wilson, M.S.W.
- Mental Health Counselor
- Los Angeles, CA
National Provider Identifier
1275763286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- ASW25311
- Practice address
- 619 E 5TH St
Los Angeles, CA 90013-2109 - Phone
- (213) 537-0822
- NPI assigned
- Jul 24, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW25311 | CA | Primary |
Addresses
Primary practice location
619 E 5TH St
Los Angeles, CA 90013-2109
Mailing address
619 E 5TH St
Los Angeles, CA 90013-2109
Phone (213) 537-0822
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
| License | State | Type | Specialty |
|---|---|---|---|
| ASW25311 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333497600000",
"number": "1275763286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 E 5TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900132109",
"telephone_number": "213-537-0822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 E 5TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900132109",
"telephone_number": "213-537-0822"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SAMUEL",
"middle_name": "BERINGER",
"name_prefix": "Mr.",
"credential": "M.S.W.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-24",
"last_updated": "2012-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW25311",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.