Heidi Ann Wilson, LPCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.0800057-SUPV Issued in OH

Practice address

405 Woodville Rd
Toledo, OH 43605-2381

Phone

(567) 318-3900

Fax

(419) 225-8878

NPI assigned

Jun 9, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Heidi Ann Farless Former name

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": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1912356023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 N WEST ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458014332",
            "telephone_number": "419-221-3072",
            "fax_number": "419-225-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 WOODVILLE RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436052381",
            "telephone_number": "567-318-3900",
            "fax_number": "419-225-8878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1045 Klotz Rd",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "OH",
            "postal_code": "434024820",
            "country_code": "US",
            "telephone_number": "419-352-7588",
            "fax_number": "419-354-4977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "HEIDI",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPCC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1300415",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0800057-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "FARLESS",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christina Ann Wilson
• Courtney Lorraine Wilson
• Debra Wilson
• Denon Wilson
• Fetema Adon Wilson, MA
• Helaine Wilson
• Jennifer Lynn Wilson, LISW-S
• Joel L Wilson, PAC
• Joelle Marie Wilson
• Jori A Wilson, SOCIAL WORKER

• Professional Counselor in Toledo, OH
• Providers in Toledo, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.