Active NPI
Susan Katrina Wilson, LMHC
- Mental Health Counselor
- Gainesville, FL
National Provider Identifier
1952510125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH7275
- Practice address
- 4300 SW 13TH St
Gainesville, FL 32608 - Phone
- (352) 374-5600
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH7275 | FL | Primary |
Addresses
Primary practice location
4300 SW 13TH St
Gainesville, FL 32608
Mailing address
4300 SW 13TH St
Gainesville, FL 32608-4006
Phone (352) 374-5600
Other practice location 1
3000 41 St.
Marathon, FL 33050
Phone (305) 434-9023
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952510125 | Other | FL | NPI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH7275 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564012800000",
"number": "1952510125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 SW 13TH ST",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326084006",
"telephone_number": "352-374-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 SW 13TH ST",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "32608",
"telephone_number": "352-374-5600"
}
],
"practiceLocations": [
{
"address_1": "3000 41 St.",
"address_purpose": "LOCATION",
"city": "Marathon",
"state": "FL",
"postal_code": "33050",
"country_code": "US",
"telephone_number": "305-434-9023",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "SUSAN",
"middle_name": "KATRINA",
"name_prefix": "Miss",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2019-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH7275",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1952510125",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.