Individual provider Active NPI

Paul Wilcox, LMFT

  • Marriage & Family Therapist
  • Carlsbad, CA
National Provider Identifier
1861103293
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT136207 Issued in CA
Practice address
785 Grand Ave Ste 212
Carlsbad, CA 92008-2371
Phone
(760) 453-7175
NPI assigned
Dec 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT136207 CA Primary

Addresses

Primary practice location

785 Grand Ave Ste 212
Carlsbad, CA 92008-2371

Mailing address

547 Boysenberry Way
Oceanside, CA 92057-4614
Phone (949) 280-1676

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL http://www.adrwellness.com

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240912004057 CA Practitioner - Marriage and Family Therapist 4486194750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adr Wellness a Professional Psychology CorporationGroup PAC ID 1456764216, 10 clinicians

Practice addresses (Care Compare)

785 Grand Ave
Suite 212
Carlsbad, CA 92008-2371
Phone (760) 453-7175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT136207CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Adr Wellness a Professional Psychology Corporation CurrentSince Sep 12, 2024 Accepting new patients

Locations

785 Grand Ave
Ste 212
Carlsbad, CA 92008
Phone (760) 453-7175

785 Grand Ave
Ste 101
Carlsbad, CA 92008
Phone (760) 720-4964

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1861103293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 BOYSENBERRY WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920574614",
            "telephone_number": "949-280-1676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 GRAND AVE STE 212",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920082371",
            "telephone_number": "760-453-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "PAUL",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT136207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.adrwellness.com",
            "affiliation": "N",
            "address_1": "785 Grand Ave Ste 212",
            "city": "Carlsbad",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920082371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

Verify at the official NPI Registry.