Lagail Jeanean Wilson, LCMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LCM756 Issued in MD

Practice address

15717 Crabbs Branch Way Ste 229
Rockville, MD 20855-6650

Phone

(301) 637-2792

Fax

(844) 375-0213

NPI assigned

Sep 15, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

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 and National Provider Directory roles.

• Open Hearts Therapy Services LLC

  • Community/Behavioral Health Agency
  • Rockville, MD
  • NPI 1558994517
  NPD Authorized official

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1356899546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17604 PHELPS HILL LN",
            "city": "DERWOOD",
            "state": "MD",
            "postal_code": "208551358",
            "telephone_number": "913-963-7133",
            "fax_number": "844-375-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15717 CRABBS BRANCH WAY STE 229",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208556650",
            "telephone_number": "301-637-2792",
            "fax_number": "844-375-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LAGAIL",
        "middle_name": "JEANEAN",
        "name_prefix": "Mrs.",
        "credential": "LCMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-15",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "2852",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "2794",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MD",
            "license": "LCM756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201229790A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jada Wilson
• Jade Wilson
• Jakailah Wilson
• Joseph Wilson
• Kadeen Wilson
• Larry Wilson
• Lucy Wilson
• Michele Wilson
• Olivia Wilson
• Pamela Wilson

• Marriage & Family Therapist in Rockville, MD
• Providers in Rockville, MD by specialty
• Marriage & Family Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; 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.