NPIMap

Individual provider Active NPI

Lee Wilson, LCDC II

  • Addiction (Substance Use Disorder) Counselor
  • San Antonio, TX
National Provider Identifier
1649404492
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
50261 Issued in OH
Practice address
4455 Horizon Hill Blvd
San Antonio, TX 78229-2258
Phone
(210) 321-2700
Fax
(210) 321-2720
NPI assigned
May 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 50261 OH Primary

Addresses

Primary practice location

4455 Horizon Hill Blvd
San Antonio, TX 78229-2258

Mailing address

4455 Horizon Hill Blvd
San Antonio, TX 78229-2258
Phone (210) 321-2700

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
50261OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Veterans Administration Past Accepting new patients
South Texas VA Past Accepting new patients

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": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1649404492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 HORIZON HILL BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292258",
            "telephone_number": "210-321-2700",
            "fax_number": "210-321-2720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 HORIZON HILL BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292258",
            "telephone_number": "210-321-2700",
            "fax_number": "210-321-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LEE",
        "credential": "LCDC II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-08",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "50261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.