Deborah Marie Wilson, LPC, EDD

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC004458 Issued in GA

Practice address

1227 Augusta West Pkwy
8
Augusta, GA 30909-6670

Phone

(706) 825-8472

Fax

(706) 825-9051

NPI assigned

Aug 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Imani House LLC

  • Community/Behavioral Health Agency
  • Augusta, GA
  • NPI 1487888566
  NPD (past) Authorized official

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1457364978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 AUGUSTA WEST PKWY",
            "address_2": "SUITE 8",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096670",
            "telephone_number": "706-825-8472",
            "fax_number": "706-825-9051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 AUGUSTA WEST PKWY",
            "address_2": "8",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096670",
            "telephone_number": "706-825-8472",
            "fax_number": "706-825-9051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DEBORAH",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "LPC, EDD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004458",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "18226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401013511",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172613501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184952006A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsey Tonitte Marie Wilson
• Christopher Ryan Wilson, MSPT
• Christy Wilson, R.N.
• Clay H Wilson, MD
• Corinne Leigh Wilson, PA-C
• Deshawn E Wilson
• Diane R Wilson, PT
• Griselda Wilson, PHARMD
• Jeanine Parks Wilson, MSN
• Jeremiah J Wilson, MD

• Professional Counselor in Augusta, GA
• Providers in Augusta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.