Organization Active NPI

Dwilson Counseling, PLLC

  • Mental Health Counselor
  • O Fallon, IL
National Provider Identifier
1457201253
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
DWILSON COUNSELING, PLLC
Practice address
640 Pierce Blvd Ste 200
O Fallon, IL 62269-2584
Phone
(618) 406-2490
NPI assigned
Jan 30, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Authorized official

Name
Dominique Wilson, LCPC
Title
Owner
Phone
(618) 406-2490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

640 Pierce Blvd Ste 200
O Fallon, IL 62269-2584

Mailing address

8703 Woods End St
San Antonio, TX 78240-3739

Other practice location 1

8703 Woods End St
San Antonio, TX 78240-3739
Phone (618) 406-2490

National Provider Directory

National Provider Directory
Tax ID family
Dwilson Counseling PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1769731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769731200000",
    "number": "1457201253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8703 WOODS END ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 PIERCE BLVD STE 200",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692584",
            "telephone_number": "618-406-2490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8703 Woods End St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782403739",
            "country_code": "US",
            "telephone_number": "618-406-2490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DWILSON COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-30",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-406-2490",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2026; 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.