Isaiah Wilson, PLADC

Key facts

NPI

1417879404

Entity type

Individual (NPI type 1)

Primary specialty

Addiction (Substance Use Disorder) Counselor 101YA0400X

License

P-2439 (NE)

Practice address

1509 1St Ave
Scottsbluff, NE 69361-3106

Phone

(308) 635-1488

NPI assigned

Jul 29, 2026

Sex

Male

Sole proprietor

No

Organizations & group practices 2

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.

• Cirrus House Inc. Community/Behavioral Health Agency · Scottsbluff, NE · NPI 1992844237
  NPD (past)
• Cirrus House, Inc. Case Management Agency · Scottsbluff, NE · NPI 1407148323
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 29, 2026.

{
    "created_epoch": "1785283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1417879404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 1ST AVE",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693613106",
            "telephone_number": "308-635-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 1ST AVE",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693613106",
            "telephone_number": "308-635-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ISAIAH",
        "credential": "PLADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-29",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "P-2439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsbluff, NE

• Blake Tyler Wills
• Daryl D Wills, D.C.
• Masumi K. Wilroy, DO
• Richard 'Gregg' Wilroy Jr., D.O.
• Caleb Wilson
• Shannon Wilson
• Caitlyn M Wimberly
• Mikaela Winters
• Duane Leroy Wirth, L.ADC
• Mark A. Wittler, D.C.

All providers in Scottsbluff, NE · Addiction (Substance Use Disorder) Counselor in Nebraska