Individual provider Active NPI

Daniel H. Wilemon, L.P.C.

  • Mental Health Counselor
  • Winston Salem, NC
National Provider Identifier
1891816633
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
682 Issued in NC
Practice address
2200 Silas Creek Pkwy
Suite 1-a
Winston Salem, NC 27103-5000
Phone
(336) 722-7300
Fax
(336) 722-7311
NPI assigned
Apr 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 682 NC Primary

Addresses

Primary practice location

2200 Silas Creek Pkwy
Suite 1-a
Winston Salem, NC 27103-5000

Mailing address

2200 Silas Creek Pkwy
Suite 1-a
Winston Salem, NC 27103-5000
Phone (336) 722-7300

Other practice location 1

175 Kimel Park Dr Ste 100
Winston Salem, NC 27103-6951
Phone (336) 718-3550

Other identifiers 2

IdentifierTypeStateIssuer
0294KOtherNCBCBSNC GROUP
890294KMedicaidNC

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

State licenses

LicenseStateTypeSpecialty
682NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1891816633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 SILAS CREEK PKWY",
            "address_2": "SUITE 1-A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035000",
            "telephone_number": "336-722-7300",
            "fax_number": "336-722-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 SILAS CREEK PKWY",
            "address_2": "SUITE 1-A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035000",
            "telephone_number": "336-722-7300",
            "fax_number": "336-722-7311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Kimel Park Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271036951",
            "country_code": "US",
            "telephone_number": "336-718-3550",
            "fax_number": "336-277-6981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILEMON",
        "first_name": "DANIEL",
        "middle_name": "H.",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC GROUP",
            "identifier": "0294K",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890294K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.