Tina Wilson, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0006382 Issued in NY

Practice address

17 South St
Cuba, NY 14727-1215

Phone

(716) 968-2004

NPI assigned

Mar 2, 2017

Last updated

Mar 19, 2024By the provider in NPPES

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

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1497295067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SOUTH ST",
            "city": "CUBA",
            "state": "NY",
            "postal_code": "147271215",
            "telephone_number": "716-968-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 SOUTH ST",
            "city": "CUBA",
            "state": "NY",
            "postal_code": "147271215",
            "telephone_number": "716-968-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TINA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-02",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "0006382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #19310)
• Meghann Kathleen Warren
• Wallace Carlisle Watson Jr., PA
• Jessika Marie Weitzel
• Jennifer Louise Williamson, MS-CCC-SLP
• Sharon Lee Wittmeyer Crowley, COTA
• Marlene Wust-Smith, MD
• Christopher L. Young, D.D.S.

• Mental Health Counselor in Cuba, NY
• Providers in Cuba, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.