Kristian Monet Wilson, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH11336 Issued in FL

Practice address

9034 Bighorn TRL
Jacksonville, FL 32222-1672

Phone

(904) 597-6303

Fax

(904) 404-8351

NPI assigned

Sep 12, 2010

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

Other names 1

• Miss Kristian Monet Samuels Former name

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Mental Health Counselor

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  GA

  Medicare reassignment Care Compare group NPD
• Aspirations Behavioral Health Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jacksonville, FL
  • NPI 1326762816
  NPD Authorized official
• Kristian Kares Kounseling

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1124478334
  NPD (past)
• Shine Medical Providers PC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1538894050
  NPD (past)

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

{
    "created_epoch": "1284249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1346557337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9034 BIGHORN TRL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322221672",
            "telephone_number": "904-597-6303",
            "fax_number": "904-404-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9034 BIGHORN TRL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322221672",
            "telephone_number": "904-597-6303",
            "fax_number": "904-404-8351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8445 English Oak Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322446988",
            "country_code": "US",
            "telephone_number": "904-524-7071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KRISTIAN",
        "middle_name": "MONET",
        "name_prefix": "Miss",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-12",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIAN",
            "last_name": "SAMUELS",
            "middle_name": "MONET",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kenneth R Wilson Sr.
• Kevin Lane Wilson, RPH
• Kiara Wilson
• Kiara Lee Wilson
• Kristen Michelle Wilson
• Kristine Ann Wilson, BS
• Laura Ann Wilson, M.A., CCC-SLP
• Linda Rene Wilson, LCSW
• Mackenzie Kyra Wilson
• Marvellicia Antoinette Wilson, RCSWI

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.

Verify at the official NPI Registry.