Organization Active NPI

Wilson Counseling & Assessment

  • Clinical Psychologist
  • Mountain BRK, AL
National Provider Identifier
1841935202
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
WILSON COUNSELING & ASSESSMENT
Practice address
3 Office Park Cir Ste 230
Mountain BRK, AL 35223-2535
Phone
(205) 616-3353
NPI assigned
Apr 30, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Dr. Michael W. Wilson, PHDNPI 1952635096
Title
Owner/Clinical Psychologist
Phone
(205) 616-3353

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

3 Office Park Cir Ste 230
Mountain BRK, AL 35223-2535

Mailing address

3050 Teresa Ave
Hueytown, AL 35023-3043
Phone (205) 616-3353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220919000095 AL Part B Supplier - Clinic/Group Practice 4183009764 Receives reassigned benefits from 1 practitioner
Practice locations: Mountain BRK, AL

National Provider Directory

National Provider Directory

Locations

4268 Cahaba Heights Ct
Ste 132
Vestavia, AL 35243
Phone (205) 616-9953

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1651276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1841935202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 TERESA AVE",
            "city": "HUEYTOWN",
            "state": "AL",
            "postal_code": "350233043",
            "telephone_number": "205-616-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 OFFICE PARK CIR STE 230",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352232535",
            "telephone_number": "205-616-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON COUNSELING & ASSESSMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-30",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "205-616-3353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain BRK, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.