Individual provider Active NPI

Pamela Denise Wilkerson

  • Professional Counselor
  • Andalusia, AL
National Provider Identifier
1538047162
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC05660 Issued in AL
Practice address
19815 Bay Branch Rd
Andalusia, AL 36420-9234
Phone
(334) 222-2523
NPI assigned
Aug 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC05660 AL Primary

Addresses

Primary practice location

19815 Bay Branch Rd
Andalusia, AL 36420-9234

Mailing address

132 Captain Quarters Dr
Andalusia, AL 36420-4922
Phone (832) 267-8019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20251029004422 AL Practitioner - Mental Health Counselor 6507355575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Central Alabama Mental Health Board IncGroup PAC ID 7517856024, 8 clinicians

Practice addresses (Care Compare)

19815 Bay Branch Rd
Andalusia, AL 36420-9234
Phone (334) 222-2525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC05660ALMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Alabama Mental Health Board Inc CurrentSince Oct 1, 2025 Accepting new patients

Locations

19815 Bay Branch Rd
Andalusia, AL 36420
Phone (334) 222-2523

820 S Three Notch St
Ste B
Andalusia, AL 36420
Phone (334) 222-2485

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1538047162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 CAPTAIN QUARTERS DR",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364204922",
            "telephone_number": "832-267-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19815 BAY BRANCH RD",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364209234",
            "telephone_number": "334-222-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "PAMELA",
        "middle_name": "DENISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-22",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "LPC05660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andalusia, AL

Sources for this page

Verify at the official NPI Registry.