Kristen Wilson, LPC, NCC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6401222505 Issued in MI

Practice address

39325 Plymouth Rd Ste 202
Livonia, MI 48150-4531

Phone

(734) 787-3802

NPI assigned

Aug 27, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kristen Matthews Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Katelin Zylka LMSW, PLLC

  • Social Worker
  • Livonia, MI
  • NPI 1073248993
  NPD
• Transformational Services LLC

  • Clinical Social Worker
  • Plymouth, MI
  • NPI 1780090258
  NPD (past)

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

{
    "created_epoch": "1598486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1902419161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 THOMAS ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481983016",
            "telephone_number": "734-787-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39325 PLYMOUTH RD STE 202",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481504531",
            "telephone_number": "734-787-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KRISTEN",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-27",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401222505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "MATTHEWS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dekenia Wilson
• Erik Wilson, GENERAL MANAGER
• Jessica Wilson
• Kennedy Wilson
• Kirbie Wilson
• Michaela Joy Wilson
• Polly Ann Wilson, LMSW
• Rebecca Wilson
• Sonya Felice Wilson
• Michelle Winalis, PTA

• Counselor in Livonia, MI
• Providers in Livonia, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.