Alvin Jody Wilson, LCDCIII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

141243 Issued in OH

Practice address

11402 State Route 50
Chillicothe, OH 45617

Phone

(740) 702-2200

Fax

(740) 702-2202

NPI assigned

Jan 17, 2018

Last updated

Jan 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1516147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516147200000",
    "number": "1992213573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 S MCARTHUR ST",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456013627",
            "telephone_number": "740-702-2200",
            "fax_number": "740-702-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11402 STATE ROUTE 50",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "45617",
            "telephone_number": "740-702-2200",
            "fax_number": "740-702-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ALVIN",
        "middle_name": "JODY",
        "credential": "LCDCIII",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-17",
        "last_updated": "2018-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "141243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany A Williamson
• Carrie Willis, LPCC-S, LICDC
• Leslie R Willis, LPN
• Rachel Lynn Willis, RN
• Vicki Willis
• Bobbi Jean Wilson, LPN
• Donna Jean Wilson
• Mandy Lynn Wilson
• Melea Beth Wilson, LMT
• Melissa Wilson

• Addiction (Substance Use Disorder) Counselor in Chillicothe, OH
• Providers in Chillicothe, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2018; 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.