Wilson Bezerra Flanders, MA, LPCC, LMHC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3902 Issued in CA

Practice address

751 Eblithedale Ave.
# 643
Mill Valley, CA 94942-0643

Phone

(415) 647-9839

Fax

(415) 390-1245

NPI assigned

Feb 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 8

Other names 1

• Mr. Wilson Bezerra-Flanders Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1720120256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 EBLITHEDALE AVE. # 643",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949420643",
            "telephone_number": "415-647-9839",
            "fax_number": "415-390-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 EBLITHEDALE AVE.",
            "address_2": "# 643",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949420643",
            "telephone_number": "415-647-9839",
            "fax_number": "415-390-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANDERS",
        "first_name": "WILSON",
        "middle_name": "BEZERRA",
        "name_prefix": "Mr.",
        "credential": "MA, LPCC, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2021-12-01",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 8586",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "3092",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "6018",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "3902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIFESYNCH/CORP HEALTH",
            "identifier": "311546",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA MILITARY",
            "identifier": "593439351",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9589228",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYNCH",
            "identifier": "267048",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL",
            "identifier": "2798432",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "311546",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "Z102-X",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2677850",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILSON",
            "last_name": "BEZERRA-FLANDERS",
            "prefix": "MR.",
            "credential": "MA, LPCC, LMHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shira Rachel Fischer, MS
• Rob Michael Fisher
• Rachel Fiske
• Ward B. Flad, MD
• Caitlin Reilly Flanagan
• Jessica Flanigan
• Catherine Flaxman, LMFT
• Kacie Flegal, D.C.
• Jai Flicker
• Laravic Trance Flores, M.D.

• Professional Counselor in Mill Valley, CA
• Providers in Mill Valley, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.