Active NPI
Holly Wilson, NCC, LPC
- Professional Counselor
- Elizabeth City, NC
National Provider Identifier
1366591869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4389
- Practice address
- 1241 N Road St
Suite a
Elizabeth City, NC 27909-3335 - Phone
- (252) 333-5519
- Fax
- (252) 335-5365
- NPI assigned
- Jan 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4389 | NC | Primary |
Addresses
Primary practice location
1241 N Road St
Suite a
Elizabeth City, NC 27909-3335
Mailing address
1241 N Road St
Suite a
Elizabeth City, NC 27909-3335
Phone (252) 333-5519
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 |
|---|---|---|---|
| 4389 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414108800000",
"number": "1366591869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1241 N ROAD ST",
"address_2": "SUITE A",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "279093335",
"telephone_number": "252-333-5519",
"fax_number": "252-335-5365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1241 N ROAD ST",
"address_2": "SUITE A",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "279093335",
"telephone_number": "252-333-5519",
"fax_number": "252-335-5365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "HOLLY",
"name_prefix": "Ms.",
"credential": "NCC, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-10",
"last_updated": "2014-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "4389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabeth City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.