Mercedes E. Wilson Dallas

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810001425 Issued in VA

Practice address

720 N Saint Asaph St
Fourth Floor
Alexandria, VA 22314-1912

Phone

(703) 838-6400

Fax

(703) 838-5070

NPI assigned

Jan 5, 2007

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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Alexandria CSB

  • Community/Behavioral Health Agency
  • Alexandria, VA
  • NPI 1457413098
  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1811044381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4906 SHARON RD",
            "city": "CAMP SPRINGS",
            "state": "MD",
            "postal_code": "207482236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N SAINT ASAPH ST",
            "address_2": "FOURTH FLOOR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223141912",
            "telephone_number": "703-838-6400",
            "fax_number": "703-838-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON DALLAS",
        "first_name": "MERCEDES",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "270291",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST BCBS",
            "identifier": "0025",
            "state": "VI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "008746A25",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "188512",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "546001103002",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claire Isabel Wills, LCSW
• Walter N Wills, M.D.
• Paula Ann Willson, ACNP
• Andrew Wilmot, PMHNP-BC
• David E. Wilsey, P.T.
• Yesenia Wilson-Cajigas
• Decatur Thomas Wilson
• Ivan Darnell Wilson
• Jessica Deniece Wilson
• Julia Catherine Wilson

• Clinical Psychologist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.