Active NPI
Kortney Brooke Wilson, CASAC
- Addiction (Substance Use Disorder) Counselor
- Bronx, NY
National Provider Identifier
1356299150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 41426
- Practice address
- 750 Astor Ave FL 2
Bronx, NY 10467-9304 - Phone
- (718) 517-9007
- Fax
- (347) 899-8057
- NPI assigned
- Mar 18, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 41426 | NY | Primary |
Addresses
Primary practice location
750 Astor Ave FL 2
Bronx, NY 10467-9304
Mailing address
3225 Olinville Ave Apt 1G
Bronx, NY 10467-6375
Phone (917) 496-5032
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41426 | NY | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773792000000",
"number": "1356299150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3225 OLINVILLE AVE APT 1G",
"city": "BRONX",
"state": "NY",
"postal_code": "104676375",
"telephone_number": "917-496-5032",
"fax_number": "347-899-8057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 ASTOR AVE FL 2",
"city": "BRONX",
"state": "NY",
"postal_code": "104679304",
"telephone_number": "718-517-9007",
"fax_number": "347-899-8057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KORTNEY",
"middle_name": "BROOKE",
"credential": "CASAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-03-18",
"last_updated": "2026-03-18",
"certification_date": "2026-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "41426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.