Individual provider Active NPI

Jessica Elaine Wilson, MA

  • Mental Health Counselor
  • Guntersville, AL
National Provider Identifier
1699131649
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2409 Homer Clayton Drive
Guntersville, AL 35976-2207
Phone
(256) 582-4240
Fax
(256) 582-4161
NPI assigned
Jan 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2409 Homer Clayton Drive
Guntersville, AL 35976-2207

Mailing address

2409 Homer Clayton Drive
Guntersville, AL 35976-2207
Phone (256) 582-4240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20250307001462 AL Practitioner - Mental Health Counselor 6709307689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Trauma, Inc.Group PAC ID 7416391818, 12 clinicians

Practice addresses (Care Compare)

3311 Bob Wallace Ave SW
Suite 103
Huntsville, AL 35805-4064
Phone (205) 705-0195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Trauma, Inc. CurrentSince Dec 27, 2024 Accepting new patients

Locations

2101 Magnolia Ave S
Ste 320
Birmingham, AL 35205

1034 23rd St S
Ste 201
Birmingham, AL 35205

3311 Bob Wallace Ave SW
Ste 103
Huntsville, AL 35805
Phone (256) 258-9341

Organizations & group practices 1

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": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1699131649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 HOMER CLAYTON DRIVE",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359762207",
            "telephone_number": "256-582-4240",
            "fax_number": "256-582-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 HOMER CLAYTON DRIVE",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359762207",
            "telephone_number": "256-582-4240",
            "fax_number": "256-582-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JESSICA",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-06",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guntersville, AL

Sources for this page

Verify at the official NPI Registry.