Donna Wilson

Primary specialty

CounselorTaxonomy code 101Y00000X

License

SW004971 Issued in FL

Practice address

7901 - 4TH St. N.
#327
St. Pete, FL 33702

Phone

(727) 374-0108

Fax

(727) 374-0108

NPI assigned

Oct 17, 2012

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles (2 of 3)

Networks

• Freedom Health HMO Network

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.

• Donna Wilson Psychotherapy Inc

  • Counselor
  • St Petersburg, FL
  • NPI 1396803078
  NPD (past) Authorized official
• Rosana Marzullo-Dove, PSYD, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tampa, FL
  • NPI 1952960684
  NPD (past)

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1487907358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 - 4TH ST. N.",
            "address_2": "#327",
            "city": "ST. PETE",
            "state": "FL",
            "postal_code": "33702",
            "telephone_number": "727-374-0108",
            "fax_number": "727-374-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 - 4TH ST. N.",
            "address_2": "#327",
            "city": "ST. PETE",
            "state": "FL",
            "postal_code": "33702",
            "telephone_number": "727-374-0108",
            "fax_number": "727-374-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DONNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "SW004971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Garnettiii, MSW
• Rachel Goff, M.S.
• Ramon Maisonet, M.A.
• Donald Bruce Morris, M.D., P.A.
• Telesa Andrea Reddick, CERTIFIED HAIR LOSS

• All providers in St. Pete, FL
• Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.