Active NPI
Frederick Robert Wilson, PH.D., LPCC-S
- Mental Health Counselor
- Cincinnati, OH
National Provider Identifier
1730387903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- E261-S
- Practice address
- 2347 Vine St
Cincinnati, OH 45219-1745 - Phone
- (513) 357-4602
- NPI assigned
- Jul 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | E261-S | OH | Primary |
Addresses
Primary practice location
2347 Vine St
Cincinnati, OH 45219-1745
Mailing address
5718 Yamassee Dr
Liberty TWP, OH 45011-8465
Phone (513) 205-5738
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E261-S | OH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480896000000",
"number": "1730387903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5718 YAMASSEE DR",
"city": "LIBERTY TWP",
"state": "OH",
"postal_code": "450118465",
"telephone_number": "513-205-5738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2347 VINE ST",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452191745",
"telephone_number": "513-357-4602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "FREDERICK",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "PH.D., LPCC-S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-10",
"last_updated": "2016-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E261-S",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.