Active NPI
Rosalie Brooke Wilson, LPCC
- Mental Health Counselor
- San Diego, CA
National Provider Identifier
1588914022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6561
- Practice address
- 1260 Morena Blvd
Suite 100
San Diego, CA 92110-3889 - Phone
- (619) 398-0355
- NPI assigned
- Sep 12, 2012
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | |||
| Mental Health Counselor | 101YM0800X | 6561 | CA | Primary |
Addresses
Primary practice location
1260 Morena Blvd
Suite 100
San Diego, CA 92110-3889
Mailing address
1260 Morena Blvd
Suite 100
San Diego, CA 92110-3889
Phone (619) 398-0355
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 |
|---|---|---|---|
| 6561 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561593600000",
"number": "1588914022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1260 MORENA BLVD",
"address_2": "SUITE 100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103889",
"telephone_number": "619-398-0355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1260 MORENA BLVD",
"address_2": "SUITE 100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103889",
"telephone_number": "619-398-0355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ROSALIE",
"middle_name": "BROOKE",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-12",
"last_updated": "2019-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "6561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.