Active NPI
Michael Paul Wilson, M.ED.
- Professional Counselor
- Chickasha, OK
National Provider Identifier
1356633259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4678
- Practice address
- 1309 S 13TH St
Chickasha, OK 73018-4248 - Phone
- (405) 638-0312
- NPI assigned
- May 10, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 0542036 | OK | |
| Professional Counselor | 101YP2500X | 4678 | OK | Primary |
Addresses
Primary practice location
1309 S 13TH St
Chickasha, OK 73018-4248
Mailing address
1309 S 13TH St
Chickasha, OK 73018-4248
Phone (405) 638-0312
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4678 | OK | MD | Professional Counselor |
| 0542036 | OK | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360800000000",
"number": "1356633259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1309 S 13TH ST",
"city": "CHICKASHA",
"state": "OK",
"postal_code": "730184248",
"telephone_number": "405-638-0312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1309 S 13TH ST",
"city": "CHICKASHA",
"state": "OK",
"postal_code": "730184248",
"telephone_number": "405-638-0312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MICHAEL",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"credential": "M.ED.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-05-10",
"last_updated": "2013-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "OK",
"license": "0542036",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "4678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chickasha, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.