Michelle Wilson, M.ED. LPCC, LADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1132 28TH Ave S
Suite 102
Moorhead, MN 56560-4420

Phone

(218) 422-6119

Fax

(218) 227-5377

NPI assigned

Jun 24, 2014

Last updated

Feb 15, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1497160998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 E LINCOLN AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372217",
            "telephone_number": "218-422-6119",
            "fax_number": "218-227-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 28TH AVE S",
            "address_2": "SUITE 102",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565604420",
            "telephone_number": "218-422-6119",
            "fax_number": "218-227-5377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 E Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Fergus Falls",
            "state": "MN",
            "postal_code": "565372217",
            "country_code": "US",
            "telephone_number": "218-422-6119",
            "fax_number": "218-227-5377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHELLE",
        "credential": "M.ED. LPCC, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303851",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "1520",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Alexander Williamson, O.D.
• Kaila Beth Wilner, PHARM D
• Carmen Marie Wilson
• Hope Wilson
• Jessie Wilson
• Shaina E Winning
• Wise Wellness Center LLC
• Jan Karen Witte-Bakken, PHD
• Alexander Witte
• Katelyn Wold-Clough

• Mental Health Counselor in Moorhead, MN
• Providers in Moorhead, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.