Individual provider Active NPI

Consuela Tangulia Wilds-Lewis, MS, LPC, NCC

  • Professional Counselor
  • Augusta, GA
National Provider Identifier
1942713664
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC010923 Issued in GA
Practice address
823 Broad St FL 1
Augusta, GA 30901-1214
Phone
(706) 770-4257
Fax
(706) 925-9855
NPI assigned
Nov 16, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC10860 SC
Mental Health Counselor 101YM0800X LPC010923 GA
Professional Counselor 101YP2500X LPC10860 SC
Community/Behavioral Health Agency 251S00000X 005087 GA
Professional Counselor 101YP2500X LPC010923 GA Primary

Addresses

Primary practice location

823 Broad St FL 1
Augusta, GA 30901-1214

Mailing address

3800 Blue Springs Trce
Evans, GA 30809-7246

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LPC010923GAMDProfessional Counselor
LPC10860SCMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1942713664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 BLUE SPRINGS TRCE",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308097246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 BROAD ST FL 1",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309011214",
            "telephone_number": "706-770-4257",
            "fax_number": "706-925-9855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDS-LEWIS",
        "first_name": "CONSUELA",
        "middle_name": "TANGULIA",
        "credential": "MS, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-16",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "LPC10860",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC010923",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "LPC10860",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "005087",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC010923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.