Angela Byrd Wilson, CCAC II

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

87881 Issued in GA

Practice address

5680 Fulton Industrial Blvd SW
Atlanta, GA 30336-2659

Phone

(404) 484-9640

NPI assigned

Jan 13, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1306656285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7263 BLUESTONE DR",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302961513",
            "telephone_number": "404-484-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5680 FULTON INDUSTRIAL BLVD SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303362659",
            "telephone_number": "404-484-9640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7263 Bluestone Dr",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "GA",
            "postal_code": "302961513",
            "country_code": "US",
            "telephone_number": "404-484-9640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ANGELA",
        "middle_name": "BYRD",
        "credential": "CCAC II",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "87881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyxandrea Wilson
• Amanda Renee Wilson, LCSW
• Amy Elizabeth Wilson
• Anara Wilson
• Andrien Wilson
• Arlene A Wilson, MD
• Ashley Wilson, NP
• Beverly Wilson, LMT
• Brandi Wilson, LCSW
• Brent A Wilson, MD

• Addiction (Substance Use Disorder) Counselor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Addiction (Substance Use Disorder) Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.