Active NPI
J Patrick Wilson, MA LMFT LPC-S
- Professional Counselor
- Lafayette, LA
National Provider Identifier
1386696623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2653
- Practice address
- 322 Heymann Blvd
BLDG. B, Ste. 4
Lafayette, LA 70503-2465 - Phone
- (337) 233-1775
- Fax
- (337) 233-1775
- NPI assigned
- May 16, 2006
- Last updated
- Jan 29, 2015
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2653 | LA | Primary |
| Marriage & Family Therapist | 106H00000X | 8 | LA |
Addresses
Primary practice location
322 Heymann Blvd
BLDG. B, Ste. 4
Lafayette, LA 70503-2465
Mailing address
PO Box 53527
Lafayette, LA 70505-3527
Phone (337) 233-1775
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2653 | LA | MD | Professional Counselor |
| 8 | LA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422489600000",
"number": "1386696623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 53527",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705053527",
"telephone_number": "337-233-1775",
"fax_number": "337-233-1775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "322 HEYMANN BLVD",
"address_2": "BLDG. B, STE. 4",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705032465",
"telephone_number": "337-233-1775",
"fax_number": "337-233-1775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "J",
"middle_name": "PATRICK",
"name_prefix": "Mr.",
"credential": "MA LMFT LPC-S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2015-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "2653",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "LA",
"license": "8",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.