Active NPI
Michelle Leigh Wilson, MA, LMHC
- Mental Health Counselor
- Andover, MA
National Provider Identifier
1497809800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4605
- Practice address
- 63 Park St
Andover, MA 01810-3662 - Phone
- (978) 475-1617
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4605 | MA | Primary |
Addresses
Primary practice location
63 Park St
Andover, MA 01810-3662
Mailing address
25 Stonehedge Rd
Windham, NH 03087-1251
Phone (978) 475-1617
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4605 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497809800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 STONEHEDGE RD",
"city": "WINDHAM",
"state": "NH",
"postal_code": "030871251",
"telephone_number": "978-475-1617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63 PARK ST",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018103662",
"telephone_number": "978-475-1617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MICHELLE",
"middle_name": "LEIGH",
"credential": "MA, LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "4605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.