Active NPI
Carrie Hamilton Wilson
- Professional Counselor
- Charlotte, NC
National Provider Identifier
1568920478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A15581
- Practice address
- 5200 Park Rd Ste 102C
Charlotte, NC 28209-3650 - Phone
- (704) 433-5267
- NPI assigned
- Mar 10, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Professional Counselor | 101YP2500X | A15581 | NC | Primary |
Addresses
Primary practice location
5200 Park Rd Ste 102C
Charlotte, NC 28209-3650
Mailing address
105 McConnell LDG
Kernersville, NC 27284-6047
Phone (336) 782-1038
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | simplepractice.com | Health Information Exchange (HIE) |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A15581 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cauthen Counseling and Consulting, PLLC | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Charlotte, NC
- NPI 1144710229
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660608000000",
"number": "1568920478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 MCCONNELL LDG",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272846047",
"telephone_number": "336-782-1038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5200 PARK RD STE 102C",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282093650",
"telephone_number": "704-433-5267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CARRIE",
"middle_name": "HAMILTON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-10",
"last_updated": "2022-08-16",
"certification_date": "2022-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A15581",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "simplepractice.com",
"affiliation": "N",
"endpointDescription": "simplepractice.com",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "5200 Park Rd Ste 102C",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282093650",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.