Shabazz M Wilson, M.ED.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

110 Maple St
Springfield, MA 01105-1864

Phone

(413) 732-7419

NPI assigned

Dec 5, 2006

Sex

Male

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

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

Mental Health Counselor

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Behavioral Health Network IncGroup PAC ID 3072596360, 146 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

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.

• Behavioral Health Network Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Springfield, MA
  • NPI 1477582609
  Medicare reassignment Care Compare group NPD
• Behavioral Health Network, Inc

  • Methadone Clinic
  • Springfield, MA
  • NPI 1669017653
  NPD

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841358322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 NORTHUMBERLAND ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011092606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MAPLE ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011051864",
            "telephone_number": "413-732-7419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHABAZZ",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "M.ED.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Jerome Wilson II
• Lakeya Wilson, LPN
• Leeandrew Rick Wilson
• Levonne Wilson, NP
• Sarah V Wilson, PA-C
• Shamika Wilson
• Veronica Wilson
• Jonathan Winalski, MD
• Niahz Wince, PA
• Tabatha Winch

• Mental Health Counselor in Springfield, MA
• Providers in Springfield, MA by specialty
• Mental Health Counselor in Massachusetts

• 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.
• 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.