Active NPI
Brian A. Wilson, M.A., LMFT
- Marriage & Family Therapist
- Monrovia, CA
National Provider Identifier
1588952204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 93754
- Practice address
- 507 W Foothill Blvd # B
Monrovia, CA 91016-2021 - Phone
- (626) 427-7357
- Fax
- (818) 243-5431
- NPI assigned
- Jul 14, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 93754 | CA | Primary |
Addresses
Primary practice location
507 W Foothill Blvd # B
Monrovia, CA 91016-2021
Mailing address
PO Box 153
Monrovia, CA 91017-0153
Phone (818) 524-9282
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 93754 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595894400000",
"number": "1588952204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 153",
"city": "MONROVIA",
"state": "CA",
"postal_code": "910170153",
"telephone_number": "818-524-9282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "507 W FOOTHILL BLVD # B",
"city": "MONROVIA",
"state": "CA",
"postal_code": "910162021",
"telephone_number": "626-427-7357",
"fax_number": "818-243-5431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "BRIAN",
"middle_name": "A.",
"credential": "M.A., LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-14",
"last_updated": "2020-07-28",
"certification_date": "2020-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "93754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monrovia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.