Allison Renee Wilson, MS, LPC
Individual provider Active NPI Professional Counselor · Traverse City, MI
NPI 1699217372 · NPPES record last updated Jan 27, 2021
Key facts
- NPI
- 1699217372
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 6401014782 (MI)
- Practice address
- 3785 Veterans Dr
Traverse City, MI 49684-4516 - Phone
- (231) 943-2084
- NPI assigned
- Nov 10, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250611002261 | MI | Practitioner - Mental Health Counselor | 5294123519 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401014782 | MI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roots Counseling & Consultation LLC | Counselor | Current |
Accepting new patients |
Locations
856 E Eighth St
Ste 1
Traverse City, MI 49686
Phone (248) 882-1338
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401017682 | MI | |
| Professional Counselor | 101YP2500X | 6401014782 | MI | Yes |
Addresses
Primary practice location
3785 Veterans Dr
Traverse City, MI 49684-4516
Mailing address
10220 Coster Rd SW
Fife Lake, MI 49633-8218
Phone (248) 882-1338
Other providers in Traverse City, MI
- Grace Willow
- Lindsay Sea Wills
- Ifayemi Willson
- Kristine Elizabeth Wilmoth
- Abbigale Joan Ellyn Wilson
- Hannah Marie Wilson
- Jocelyn Wilson
- Krysten Rose Wilson
- Mariah Dawn Wilson
- Marjorie S Wilson
All providers in Traverse City, MI · Professional Counselor in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.