Individual provider Active NPI

Emily Wilson, LPC

  • Counselor
  • Denton, TX
National Provider Identifier
1972127348
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
80977 Issued in TX
Practice address
519 S Carroll Blvd Ste 100
Denton, TX 76201-7412
Phone
(940) 230-2003
Fax
(940) 222-4648
NPI assigned
Jun 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 80977 TX Primary
Professional Counselor 101YP2500X 80977 TX

Addresses

Primary practice location

519 S Carroll Blvd Ste 100
Denton, TX 76201-7412

Mailing address

8216 Oak Creek LN
Denton, TX 76208-2183
Phone (940) 230-2003

Other practice location 1

2556 Lillian Miller Pkwy Ste 201
Denton, TX 76210-7207
Phone (940) 230-2003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20240605000678 TX Practitioner - Mental Health Counselor 6204294838 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
80977TXMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Life Counseling, PLLC Counselor CurrentSince Jun 2, 2023 Accepting new patients
Sereneco Wellness Professional PastSince Jul 12, 2020 Accepting new patients
Sereneco Wellness Center LLC PastSince Sep 4, 2022 Accepting new patients
Solutions Medical Clinic PastSince Apr 16, 2023 Accepting new patients

Locations

519 S Carroll Blvd
Ste 100
Denton, TX 76201
Phone (940) 230-2003

2556 Lillian Miller Pkwy
Ste 102
Denton, TX 76210

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1972127348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8216 OAK CREEK LN",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762082183",
            "telephone_number": "940-230-2003",
            "fax_number": "940-222-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 S CARROLL BLVD STE 100",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762017412",
            "telephone_number": "940-230-2003",
            "fax_number": "940-222-4648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2556 Lillian Miller Pkwy Ste 201",
            "address_purpose": "LOCATION",
            "city": "Denton",
            "state": "TX",
            "postal_code": "762107207",
            "country_code": "US",
            "telephone_number": "940-230-2003",
            "fax_number": "940-222-4648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "EMILY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "80977",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "80977",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

Verify at the official NPI Registry.