Matthew James Wilson, LMHCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC60703724 Issued in WA

Practice address

5197 NW Lower River Rd BLDG Ste1
Vancouver, WA 98660-1013

Phone

(229) 315-1333

NPI assigned

Sep 23, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Matthew James Wilson Professional name

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": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1336575208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5197 NW LOWER RIVER RD BLDG STE1",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986601013",
            "telephone_number": "229-315-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5197 NW LOWER RIVER RD BLDG STE1",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986601013",
            "telephone_number": "229-315-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "credential": "LMHCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-23",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60703724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATTHEW",
            "last_name": "WILSON",
            "middle_name": "JAMES",
            "credential": "MC60703724",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kip L Wilson, LMP LMT
• Kyle Richard Ikaika Wilson, DC
• Lizamarie Ann Wilson, CPC
• Marguerite Claire Wilson, PHD
• Martha E Wilson, MA
• Poppy Wilson Sr.
• Roxanne Wilson
• Savanna Deloris Wilson
• Timothy J Wilson Jr.
• William Shane Wilson

• Mental Health Counselor in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.