Michelle Wilson, CADC I

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CI06351016 Issued in CA

Practice address

20331 Flanagan Road
Trabuco Canyon, CA 92679

Phone

(818) 582-8832

Fax

(818) 582-8836

NPI assigned

Jun 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Teen Project, Inc.

  • Children's Substance Abuse Rehabilitation Facility
  • Trabuco Canyon, CA
  • NPI 1609345743
  NPD (past)

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1922624196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27091 PINARIO",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926923204",
            "telephone_number": "949-619-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20331 FLANAGAN ROAD",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "92679",
            "telephone_number": "818-582-8832",
            "fax_number": "818-582-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHELLE",
        "credential": "CADC I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CI06351016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meaghan Walter
• Christopher Washington
• Megan Louise-Marie Wenzel, RADT
• Brianne Leslie Wilson, RADT
• Catherine Wilson
• Cambria Witten
• Stephanie Zaugg
• Vanessa Elizabeth Zelaya
• Jenna Lynn Zottarelli, MSW, M.A.
• John Paul Zuniga, RADT

• Addiction (Substance Use Disorder) Counselor in Trabuco Canyon, CA
• Providers in Trabuco Canyon, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

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