Individual provider Active NPI

Alan Eric Wilson

  • Professional Counselor
  • Encinitas, CA
National Provider Identifier
1619621307
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
27605 Issued in CA
Practice address
925 N Vulcan Ave Apt 209
Encinitas, CA 92024-1780
Phone
(541) 728-8062
NPI assigned
Feb 10, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 27605 CA Primary

Addresses

Primary practice location

925 N Vulcan Ave Apt 209
Encinitas, CA 92024-1780

Mailing address

925 N Vulcan Ave Apt 209
Encinitas, CA 92024-1780
Phone (541) 728-8062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20240722001660 CA Practitioner - Marriage and Family Therapist 6901342377 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for New Directions, Inc. CurrentSince Apr 11, 2024 Accepting new patients
Stephen M Pumphrey Licensed Clinical Social Workers Inc PastSince Dec 25, 2018 Accepting new patients

Locations

23201 Mill Creek Dr
Ste 220
Laguna Hills, CA 92653
Phone (949) 460-5320

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1619621307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 N VULCAN AVE APT 209",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241780",
            "telephone_number": "541-728-8062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 N VULCAN AVE APT 209",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241780",
            "telephone_number": "541-728-8062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ALAN",
        "middle_name": "ERIC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "27605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.