Individual provider Active NPI

Michel R Wilson, LPC

  • Mental Health Counselor
  • Conroe, TX
National Provider Identifier
1477721017
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
61995 Issued in TX
Practice address
704 N Thompson St Ste 190
Conroe, TX 77301-2579
Phone
(832) 790-4642
NPI assigned
Feb 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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 61995 TX Primary

Addresses

Primary practice location

704 N Thompson St Ste 190
Conroe, TX 77301-2579

Mailing address

704 N Thompson St Ste 190
Conroe, TX 77301-2579
Phone (832) 790-4642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20260402002203 TX Practitioner - Mental Health Counselor 1153806591 Practice locations: Conroe, TX

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

159 E Double CRK
Willis, TX 77378-3174

704 N Thompson
Suite 190
Willis, TX 77378

704 N Thompson St
Suite 190
Conroe, TX 77301-2579
Phone (832) 790-4642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61995TXMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1477721017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 N THOMPSON ST STE 190",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773012579",
            "telephone_number": "832-790-4642",
            "fax_number": "888-446-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 N THOMPSON ST STE 190",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773012579",
            "telephone_number": "832-790-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHEL",
        "middle_name": "R",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-18",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "61995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.