Wilson'S Garden of Hope

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC006436 Issued in GA

Legal business name

WILSON'S GARDEN OF HOPE

Practice address

3062 Damascus Rd
Suite 100
Augusta, GA 30909-4068

Phone

(762) 233-4642

NPI assigned

Jun 12, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Shatisha Matrice Wilson, M.S.NPI 1073953253

Title

Executive Director

Phone

(762) 233-4642

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shatisha Matrice Wilson, MS, LPC, RPT-S, ACS

  • Professional Counselor
  • Martinez, GA
  • NPI 1073953253
  NPD Authorized official

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370995200000",
    "number": "1710325766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3478 ESSEX PL",
            "city": "HEPHZIBAH",
            "state": "GA",
            "postal_code": "308157172",
            "telephone_number": "762-233-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3062 DAMASCUS RD",
            "address_2": "SUITE 100",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309094068",
            "telephone_number": "762-233-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON'S GARDEN OF HOPE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SHATISHA",
        "authorized_official_middle_name": "MATRICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "762-233-4642",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LAPC002949",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC006436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Daniel Wilson, DNAP, CRNA
• Nathan A. Wilson, M.D.
• Tamara Wilson
• Taylor Gale Wilson, MD
• Wanda Marie Wilson
• Kailah J Wimberly
• Yonisha Leigh Wimberly, FNP-BC
• Tomeika Michelle Wimbush
• Nicole Wimmer, NP
• Windermere Health Center by Harborview, LLC

• Professional Counselor in Augusta, GA
• Providers in Augusta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.