Mia Phyu Wilson

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1904 Issued in MA

Practice address

21 Griffin Rd
Londonderry, NH 03053

Phone

(978) 987-1291

NPI assigned

Sep 7, 2017

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

Other names 1

• Mia Phyu Win Former name

Medicare fee-for-service enrollment

Enrolled in MA

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 1

Specialty

Marriage and Family Therapist

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Vinfen Corporation

  • Community/Behavioral Health Agency
  • Cambridge, MA
  • NPI 1225168271
  NPD

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1801314141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GRIFFIN RD",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "03053",
            "telephone_number": "978-987-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GRIFFIN RD",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "03053",
            "telephone_number": "978-987-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MIA",
        "middle_name": "PHYU",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-07",
        "last_updated": "2024-02-06",
        "certification_date": "2024-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MA",
            "license": "1904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIA",
            "last_name": "WIN",
            "middle_name": "PHYU",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katharine Laura Wetherbee, D.O.
• Rachel Marie Wetson, PHARMD
• Deborah E Whitney, OTR/L
• Brian Wienzek, RPH
• Steve Harry Willnus, R.PH.
• Joseph Leon Wingate, DDS
• Jeanne M Wissler, MSW
• Lisa Gay Witham, ATC, LAT
• Kimberly Wong
• Shona Woods

• Marriage & Family Therapist in Londonderry, NH
• Providers in Londonderry, NH by specialty
• Marriage & Family Therapist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.