Alicia Lynn Wimsatt, LPC ASSOCIATE

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

90736 Issued in TX

Practice address

620 Stoneglen Dr Ste B
Keller, TX 76248-3625

Phone

(817) 562-8800

NPI assigned

Jun 5, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Redefine LLC

  • Marriage & Family Therapist
  • Keller, TX
  • NPI 1134773997
  NPD

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1336833367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SHADY SPRINGS DR",
            "city": "RUNAWAY BAY",
            "state": "TX",
            "postal_code": "764261408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 STONEGLEN DR STE B",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483625",
            "telephone_number": "817-562-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Shady Springs Dr",
            "address_purpose": "LOCATION",
            "city": "Runaway Bay",
            "state": "TX",
            "postal_code": "764261408",
            "country_code": "US",
            "telephone_number": "940-389-4030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIMSATT",
        "first_name": "ALICIA",
        "middle_name": "LYNN",
        "credential": "LPC ASSOCIATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "90736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexys Shyanne Wilson-Walker
• Jacqueline Wilson, FNP
• Meagan Wilson, MS. SLP CCC
• Melissa Ann Wilson, APRN, FNP-C
• Tionne Wilson
• With Purpose Health & Wellness Center
• Roni Withers, RBT
• Womack's Family Fitness, Inc (Womacks Rehabilitation Center)
• Alice Wong
• Kin S Wong, D.O.

• Professional Counselor in Keller, TX
• Providers in Keller, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.