Woodrow Wilson III, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P1012081 Issued in AR

Practice address

3305 E Highland Dr Ste B
Jonesboro, AR 72401-6491

Phone

(870) 520-5014

Fax

(870) 520-5015

NPI assigned

Sep 9, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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.

• The Logan Centers, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jonesboro, AR
  • NPI 1932119187

  Professional

  Medicare reassignment NPD
• Optum Behavioral Care of North Carolina, P.C.

  • Clinical Social Worker
  • Little Rock, AR
  • NPI 1053298711
  NPD (past)

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1992087589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11064",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031001",
            "telephone_number": "870-520-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 E HIGHLAND DR STE B",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016491",
            "telephone_number": "870-520-5014",
            "fax_number": "870-520-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "WOODROW",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-09",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1012081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228145719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matt Wilson
• Myla Marie Wilson, RN
• Nicholas K Wilson, MHPP
• Regina Wilson
• Sarah Nicole Wilson, LAC
• Joshua Wingo
• Michelle Wingo, P.A.
• Magan Winn
• Morgan T Winningham
• Allison Winters

• Professional Counselor in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.