Fred Wilson Sr.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

945 N Liberty St
Apt B219
Jacksonville, FL 32206-5676

Phone

(904) 238-1240

Fax

(904) 358-1551

NPI assigned

Oct 1, 2014

Last updated

Oct 1, 2014By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1396148623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 N LIBERTY ST",
            "address_2": "APT B219",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322065676",
            "telephone_number": "904-238-1240",
            "fax_number": "904-358-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 N LIBERTY ST",
            "address_2": "APT B219",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322065676",
            "telephone_number": "904-238-1240",
            "fax_number": "904-358-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "FRED",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Wilson, MSW
• Courtney Elaine Wilson, DPT
• Eleni- Claire Wilson
• Emanuel Dwayne Wilson, DC
• Frances Wilson
• Fred Carter Wilson, D.C.
• Gail Wilson, MS
• George Rice Wilson III, MD
• Gloria Wilson
• Hazel Wilson

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.

Verify at the official NPI Registry.