David Wilson, LLPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401019214 Issued in MI

Practice address

781 Kenmoor Ave SE Ste C
Grand Rapids, MI 49546-8624

Phone

(616) 200-4433

NPI assigned

Jul 12, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Meghan McLain PC

  • Counseling Psychologist
  • Grand Rapids, MI
  • NPI 1538815709
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  MI, Professional

  Medicare reassignment NPD
• Rockford Speech Therapy, LLC

  • Speech-Language Pathologist
  • Rockford, MI
  • NPI 1831727585
  NPD (past)

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1952973737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5844 DIX DR NE",
            "city": "BELMONT",
            "state": "MI",
            "postal_code": "493069059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 KENMOOR AVE SE STE C",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468624",
            "telephone_number": "616-200-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DAVID",
        "credential": "LLPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401019214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "W425135661744",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brantley Michelle Wilson
• Brieanne Sue Wilson, MD
• Bryant Thomas Wilson, PA-C
• Conner Wilson, DO
• Daniel Christopher Wilson, NP
• Deasia Wilson, BEHAVIOR TECHNICIAN
• Elizabeth Wilson
• Emari Wilson
• Emily Anne Wilson, FNP
• Emily Jean Wilson, AGNP-C

• Professional Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.