Active NPI
Gillian Wilson, PH.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1891366548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 025196
- Practice address
- 175 W 13TH St Apt 1B
New York, NY 10011-7803 - Phone
- (929) 457-1452
- NPI assigned
- Jul 5, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 025196 | NY | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | P103064 | NY |
Addresses
Primary practice location
175 W 13TH St Apt 1B
New York, NY 10011-7803
Mailing address
175 W 13TH St Apt 1B
New York, NY 10011-7803
Phone (929) 457-1452
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025196 | NY | MD | Physician Assistant |
| P103064 | NY | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664841600000",
"number": "1891366548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 W 13TH ST APT 1B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100117803",
"telephone_number": "929-457-1452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 W 13TH ST APT 1B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100117803",
"telephone_number": "929-457-1452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "GILLIAN",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-05",
"last_updated": "2022-10-04",
"certification_date": "2022-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "025196",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NY",
"license": "P103064",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.