Individual provider Active NPI

Christena Wilkerson, LMHC

  • Mental Health Counselor
  • Indianapolis, IN
National Provider Identifier
1467057174
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39002880A Issued in IN
Practice address
2506 Willowbrook Pkwy Ste 102
Indianapolis, IN 46205-1542
Phone
(765) 667-1963
NPI assigned
Dec 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39002880A IN Primary

Addresses

Primary practice location

2506 Willowbrook Pkwy Ste 102
Indianapolis, IN 46205-1542

Mailing address

2506 Willowbrook Pkwy Ste 102
Indianapolis, IN 46205-1542
Phone (765) 667-1963

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20240524000170 IN Practitioner - Mental Health Counselor 0749622504 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Health Services Corp CurrentSince Apr 3, 2024 Accepting new patients
Meridian Health Services Corp. CurrentSince Apr 3, 2024 Accepting new patients

Locations

2506 Willowbrook Pkwy
Ste 102
Indianapolis, IN 46205
Phone (317) 650-4752

240 N Tillotson Ave
Muncie, IN 47304

Interoperability endpoints

  • Direct secure messaging: christena.wilkerson.p1@direct.meridianhs.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1467057174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 WILLOWBROOK PKWY STE 102",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051542",
            "telephone_number": "765-667-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2506 WILLOWBROOK PKWY STE 102",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051542",
            "telephone_number": "765-667-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "CHRISTENA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002880A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.