Mary Judith Wilson, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E3422 Issued in OH

Practice address

245 West Elmwood Dr.
Centerville, OH 45459

Phone

(937) 432-0766

Fax

(937) 432-0768

NPI assigned

Dec 11, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770643983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3559 STRATHMOOR DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291519",
            "telephone_number": "937-299-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 WEST ELMWOOD DR.",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "45459",
            "telephone_number": "937-432-0766",
            "fax_number": "937-432-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARY",
        "middle_name": "JUDITH",
        "name_prefix": "Ms.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E3422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristi Dawn Williams
• Austin Willis
• Julie Kaye Wilson Ellis, LPN
• Chey-Anne L Wilson, IMFT
• Marcia Wilson
• Shelby Raylynn Wilson, OTR/L
• Elin Winninge-Oakes, RBT
• Joy L Witwer, LISW-SUPV
• Kevin Andrew Wolf, PT, DPT
• Christin Taylor Wolfram, NP

• Mental Health Counselor in Centerville, OH
• Providers in Centerville, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.