Individual provider Active NPI

Cynthia Pretrice Wilson

  • Counselor
  • Tuskegee, AL
National Provider Identifier
1619605169
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
ALCO3355 Issued in AL
Practice address
608 Dibble St
Tuskegee, AL 36083-1509
Phone
(334) 947-5901
NPI assigned
Aug 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X ALCO3355 AL Primary

Addresses

Primary practice location

608 Dibble St
Tuskegee, AL 36083-1509

Mailing address

2261 Semmes Dr
Montgomery, AL 36106-3401
Phone (334) 391-7225

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

LicenseStateTypeSpecialty
ALCO3355ALMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1619605169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2261 SEMMES DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063401",
            "telephone_number": "334-391-7225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 DIBBLE ST",
            "city": "TUSKEGEE",
            "state": "AL",
            "postal_code": "360831509",
            "telephone_number": "334-947-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CYNTHIA",
        "middle_name": "PRETRICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "AL",
            "license": "ALCO3355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuskegee, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.

Verify at the official NPI Registry.