Laurrel Susan Wilson, CDP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

60604431 Issued in WA

Practice address

5900 W 17TH Ave
Kennewick, WA 99338-1409

Phone

(509) 572-0633

NPI assigned

May 19, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lauri Wilson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1992152995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 W 17TH AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993381409",
            "telephone_number": "509-572-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 W 17TH AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993381409",
            "telephone_number": "509-572-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LAURREL",
        "middle_name": "SUSAN",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-19",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "60604431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURI",
            "last_name": "WILSON",
            "credential": "CDP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lysle Westley Williams Jr., M.D.
• James Edwin Willis
• Mauri Kirsten Joy Willis, RDH
• Amanda Susanna Willms, L.M.P.
• Donald Wilson
• Madison Wilson
• Matthew Wilson, LCMHC
• Susan P Wilson, RPH
• Alexa Wilt
• Brian Henry Wingert, PTA

• Professional Counselor in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Professional Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.