Malcolm James Wilson Jr., M.A. LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

312 McLean St
Boyne City, MI 49712-9444

Phone

(989) 600-7035

NPI assigned

Jun 12, 2012

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 MI

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Wilson Wellness Counseling, Coaching & Consulting LLC

  • Professional Counselor
  • Petoskey, MI
  • NPI 1427828979
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510617600000",
    "number": "1548522899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 MCLEAN ST",
            "city": "BOYNE CITY",
            "state": "MI",
            "postal_code": "497129444",
            "telephone_number": "989-600-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 MCLEAN ST",
            "city": "BOYNE CITY",
            "state": "MI",
            "postal_code": "497129444",
            "telephone_number": "989-600-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MALCOLM",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "M.A. LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Marie Valliere, MA, LPC, NCC
• Rebecca L Verville, LMSW
• Robert S Wedge, CRNA
• Andrea L Wendling, MD
• Maryellen Werstine, LMT
• Catherine A Wonski, MD
• Jessica Wright

• Professional Counselor in Boyne City, MI
• Providers in Boyne City, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; 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.