Daryl Kaye Wilson

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704393729 Issued in MI

Practice address

10801 S Saginaw St Ste D
Grand Blanc, MI 48439-8126

Phone

(810) 771-4074

Fax

(810) 662-0672

NPI assigned

Sep 8, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Creekside Counseling Group LLCGroup PAC ID 9133521255, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Creekside Counseling Group LLC

  • Clinical Social Worker
  • Grand Blanc, MI
  • NPI 1619550860

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1386524494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10801 S SAGINAW ST STE D",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398126",
            "fax_number": "810-662-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 S SAGINAW ST STE D",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398126",
            "telephone_number": "810-771-4074",
            "fax_number": "810-662-0672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DARYL",
        "middle_name": "KAYE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-08",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704393729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Anne Williams
• Jolonda Williams
• Kereen Williams
• Nekeisha N Willis
• Andrew Harvey Wilson
• Ian Wilson
• Kristi Jo Wilson, F.N.P. - B.C
• Lisa D Wilson, RN
• Mandi Withey, LLP
• Jacqueline Wodyka, O.D.

• Psychiatric/Mental Health Nurse Practitioner in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; 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.