Charles Lynn Wilson Jr., MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10690 Issued in OK

Practice address

1402 N Florence Ave Ste B
Claremore, OK 74017-3159

Phone

(918) 608-0380

Fax

(209) 425-5727

NPI assigned

Jun 25, 2017

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

Enrolled in OK

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Alliance Mental Health, LLC

  dba YCO Alliance

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Claremore, OK
  • NPI 1053602649
  Medicare reassignment NPD
• Alliance Mental Health, LLC

  • Mental Health Counselor
  • Saddle River, NJ
  • NPI 1285520726
  NPD
• Improving Lives Counseling Services, Inc.

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1487967444
  NPD (past)

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

{
    "created_epoch": "1498348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1447770086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 N FLORENCE AVE STE B",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740173159",
            "telephone_number": "186-080-3809",
            "fax_number": "209-425-5727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 N FLORENCE AVE STE B",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740173159",
            "telephone_number": "918-608-0380",
            "fax_number": "209-425-5727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHARLES",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-25",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "10690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cymonne Williamson
• Cory Wilsey, DC
• Lillian Josette Wilsey, DC
• Aaron Wilson
• Amanda Kay Wilson
• Gary M Wilson
• Nickie Deann Wilson, LADC/MH
• Shae Wilson
• Sherry Mae Wilson, RN
• Valerie Rachelle Wilson, DNP, FNP-C

• Mental Health Counselor in Claremore, OK
• Providers in Claremore, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.