Kristine D Wilson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2131 Issued in MS

Practice address

368 Courthouse Rd Ste D
Gulfport, MS 39507-1854

Phone

(228) 341-1079

NPI assigned

Apr 21, 2017

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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 1

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Resonance Professional Counseling

  • Professional Counselor
  • Gulfport, MS
  • NPI 1326605601
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725667200000",
    "number": "1346775863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15256 THREE RIVERS RD",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395328066",
            "telephone_number": "228-341-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 COURTHOUSE RD STE D",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395071854",
            "telephone_number": "228-341-1079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15256 Three Rivers Rd",
            "address_purpose": "LOCATION",
            "city": "Biloxi",
            "state": "MS",
            "postal_code": "395328066",
            "country_code": "US",
            "telephone_number": "228-341-1079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KRISTINE",
        "middle_name": "D",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-21",
        "last_updated": "2024-09-07",
        "certification_date": "2024-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "2131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05278341",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric L Wills, LCSW
• Charla Ann Wilson
• David Charles Wilson, LMFT
• David John Wilson, MS,LPC
• Grant Christopher Wilson, DO
• Lydia Faith Wilson
• Tiyahri Cheriece Wilson, M.S.
• Victor J Wilson
• Ashira Windsor, MSW, LCSW
• Angela Booth Wingfield, MD

• Professional Counselor in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2024; 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.