Active NPI
Fashen Lashawntra Wilson, MSW
- Mental Health Counselor
- West Palm Beach, FL
National Provider Identifier
1285350637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- ISW14780
- Practice address
- 1639 Forum PL Ste 7
West Palm Beach, FL 33401-2330 - Phone
- (561) 889-9191
- NPI assigned
- Oct 18, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | ISW14780 | FL | Primary |
Addresses
Primary practice location
1639 Forum PL Ste 7
West Palm Beach, FL 33401-2330
Mailing address
1639 Forum PL Ste 7
West Palm Beach, FL 33401-2330
Phone (561) 889-9191
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW14780 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Mental Health | Current | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598
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": "1666051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666051200000",
"number": "1285350637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1639 FORUM PL STE 7",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334012330",
"telephone_number": "561-889-9191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1639 FORUM PL STE 7",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334012330",
"telephone_number": "561-889-9191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "FASHEN",
"middle_name": "LASHAWNTRA",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-18",
"last_updated": "2022-10-18",
"certification_date": "2022-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "ISW14780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.