Ishalon Shanquell Siedah Wilson, LMHC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

99718 Issued in TX

Practice address

4090 SW Jaqust St
Port St Lucie, FL 34953-5626

Phone

(850) 631-0977

NPI assigned

Jun 25, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Isha Wilson Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL, TX2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Shardae Tripp Counseling LLCGroup PAC ID 5496101784, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Shardae Tripp Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Port Saint Lucie, FL
  • NPI 1801583646
  Medicare reassignment Care Compare group NPD
• Alaniz Counseling and Behavioral Center, P.C.

  • Professional Counselor
  • San Antonio, TX
  • NPI 1811288731
  Medicare reassignment NPD
• Vcounselors PLLC

  • Professional Counselor
  • San Antonio, TX
  • NPI 1326784307
  NPD

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1750126470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4090 SW JAQUST ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349535626",
            "telephone_number": "850-631-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4090 SW JAQUST ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349535626",
            "telephone_number": "850-631-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ISHALON",
        "middle_name": "SHANQUELL SIEDAH",
        "credential": "LMHC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH23967",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "99718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "IshalonWilson@gmail.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4090 SW Jaqust St",
            "city": "Port St Lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349535626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ISHA",
            "last_name": "WILSON",
            "credential": "LMHC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Masiai Willis-Jones, APRN FNP-C
• Charnelle Willis
• Wilnique Peaceful Adult Family Care Home
• Ann L Wilson, DDS
• Gavin Keith Wilson, PA
• James E Wilson, PA-C
• Jerisha Wilson, RCSWI, LMSW
• Jessica Wilson
• Kaley Noelle Wimmer
• Robin Winkler

• Professional Counselor in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Professional Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.