Kenneth Spencer Wilson, PHD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

966 Issued in OK

Practice address

501 S Johnstone Ave
Bartlesville, OK 74003-6609

Phone

(918) 337-6050

Fax

(918) 336-6061

NPI assigned

May 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kristin Leean Wilson Professional name

Medicare fee-for-service enrollment

Enrolled in OK

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

Clinical Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wilson Psychological Associates PLLCGroup PAC ID 7113907452, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Wilson Psychological Associates PLLC

  • Psychologist
  • Bartlesville, OK
  • NPI 1144326265
  Medicare reassignment Care Compare group NPD Authorized official
• Wilson Psychological Assessments, PLLC

  • Clinical Psychologist
  • Bartlesville, OK
  • NPI 1427903541
  NPD Authorized official

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366400707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S JOHNSTONE AVE",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740036638",
            "telephone_number": "918-337-6050",
            "fax_number": "918-336-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S JOHNSTONE AVE",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740036609",
            "telephone_number": "918-337-6050",
            "fax_number": "918-336-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KENNETH",
        "middle_name": "SPENCER",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OK",
            "license": "966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "WILSON",
            "middle_name": "LEEAN",
            "prefix": "MS.",
            "credential": "LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Wilson Psychological Assessments, PLLC
• Wilson Psychological Associates PLLC
• Da'Nae Wilson
• John R Wilson, BOCPO
• Katherine Ann Wilson, MA
• Kristin Leean Wilson, LPC
• Sherry M Wilson, LPC
• Sloan Andrew Wilson
• Tatiana A Wilson
• Tracy Leigh Winner

• Counseling Psychologist in Bartlesville, OK
• Providers in Bartlesville, OK by specialty
• Counseling Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.