Vanita J Wilson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401010431 Issued in MI

Practice address

1140 S Linden Rd
Flint, MI 48532-3437

Phone

(810) 240-9472

NPI assigned

Oct 16, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vanita.wilson.1@28621.direct.athenahealth.com

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.

• Optum Behavioral Care of Colorado, P.C.

  dba Oakland Psychological Clinic of Michigan

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomfield Hills, MI
  • NPI 1376300616
  NPD
• Optum Behavioral Care of Colorado, P.C.

  dba Oakland Psychological Clinic of Michigan

  • Clinical Psychologist
  • Bloomfield Hills, MI
  • NPI 1851161285
  NPD
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Social Worker
  • De Pere, WI
  • NPI 1396622494
  NPD
• Downtown Wellness PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Holly, MI
  • NPI 1063193233
  NPD (past)

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1740756949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11237 W PIERSON RD",
            "city": "FLUSHING",
            "state": "MI",
            "postal_code": "484339740",
            "telephone_number": "810-955-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 S LINDEN RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323437",
            "telephone_number": "810-240-9472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "VANITA",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401010431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quinise Wilson
• Samantha Kai Wilson, PRC
• Sherrell Wilson, LLPC
• Stacie Dionne Wilson, MSW
• Sydney Wilson
• Karen Jean Wiltse, ANP
• Shannon Wiltse, MS, CGC
• Wade B Wines, PAC
• Amber Wing
• Aaron Winston, LBSW

• Professional Counselor in Flint, MI
• Providers in Flint, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.