Timothy Wilson, MA, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0704012471 Issued in VA

Practice address

1047 Vista Park Dr Ste a
Forest, VA 24551-4362

Phone

(434) 616-2388

NPI assigned

Mar 3, 2021

Sex

Male

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 VA

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

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sitting Well at the Well IncGroup PAC ID 6709374325, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Sitting Well at the Well Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lynchburg, VA
  • NPI 1801526991
  Medicare reassignment Care Compare group NPD
• Advanced Psychotherapeutics

  • Clinical Psychologist
  • Forest, VA
  • NPI 1053793059

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1497340244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1047 VISTA PARK DR STE A",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245514362",
            "telephone_number": "434-616-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1047 VISTA PARK DR STE A",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245514362",
            "telephone_number": "434-616-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "credential": "MA, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0704012471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Eileen Wilkins
• Asiana Williams
• Kathryn J Williamson, PT
• Edward Willis
• David Coleman Wilson, M.D.
• Wimmer Chiropractic, PC
• David Wimmer, D.C.
• Katelin Victoria Wines
• Emily Nichole Wingfield, LPC
• Jessica S Winn, PSY.D; LMFT

• Mental Health Counselor in Forest, VA
• Providers in Forest, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.