Lawrence Edward Wilson, NACAII, LADACII,

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LDC0000000344 Issued in TN

Practice address

1548 Poplar Ave
Memphis, TN 38104-2432

Phone

(901) 277-6101

Fax

(901) 729-2933

NPI assigned

Jun 28, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498608000000",
    "number": "1902327018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3543 PHILSDALE AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381115450",
            "telephone_number": "901-277-6101",
            "fax_number": "901-729-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1548 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042432",
            "telephone_number": "901-277-6101",
            "fax_number": "901-729-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LAWRENCE",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "NACAII,  LADACII,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-28",
        "last_updated": "2017-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "016414",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "LDC0000000344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Y Wilson
• Kayla Wilson, OTR/L
• Keadrea Wilson
• Kimber Wilson
• Kimberly T Wilson, C-NP
• Lee Eugene Wilson, D.D.S.
• Luke Wilson
• Madison Wilson, BSW
• Matthew Clark Wilson, PHARMD
• Matthew W Wilson, MD

• Addiction (Substance Use Disorder) Counselor in Memphis, TN
• Providers in Memphis, TN by specialty
• Addiction (Substance Use Disorder) Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2017; 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.