Jerisha Wilson, RCSWI, LMSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

13192 Issued in FL

Practice address

540 NW University Blvd Ste 204
Port St Lucie, FL 34986-2281

Phone

(772) 494-7770

NPI assigned

Dec 29, 2025

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)

Not enrolled

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.

• Shardae Tripp Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Port Saint Lucie, FL
  • NPI 1801583646

  Single Specialty

  NPD

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1538025192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 PHILLIPS RD APT 1106",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085346",
            "telephone_number": "772-494-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 NW UNIVERSITY BLVD STE 204",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862281",
            "telephone_number": "772-494-7770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2350 Phillips Rd Apt 1106",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323085346",
            "country_code": "US",
            "telephone_number": "423-463-9269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JERISHA",
        "credential": "RCSWI, LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-29",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "13192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilnique Peaceful Adult Family Care Home
• Ann L Wilson, DDS
• Gavin Keith Wilson, PA
• Ishalon Shanquell Siedah Wilson, LMHC, LPC
• James E Wilson, PA-C
• Jessica Wilson
• Kaley Noelle Wimmer
• Robin Winkler
• Sabrina Winn
• Yvette Wirta-Clarke, DO

• Mental Health Counselor in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; 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.