Stephanie Louise Wilson, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

0717001541 Issued in VA

Practice address

6010 W Broad St Ste 103
Richmond, VA 23230-2215

Phone

(804) 282-1863

NPI assigned

Mar 14, 2021

Sex

Female

Sole proprietor

Yes

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

Enrolled in VA

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

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

We Help Our AdolescentsGroup PAC ID 1850790957, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• We Help Our Adolescents

  • Community/Behavioral Health Agency
  • Richmond, VA
  • NPI 1497148480
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1615680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1992380679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 W BROAD ST STE 103",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232302215",
            "telephone_number": "804-282-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 W BROAD ST STE 103",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232302215",
            "telephone_number": "804-282-1863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STEPHANIE",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-14",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivya Wilson, LCSW
• Pam Evans Wilson, OTR
• Qunique Wilson
• Richard William Wilson, LPC LMFT
• Staci Erica Wilson, RN
• Tanaysha Ebony Wilson, MSW, LCSW
• Teresh Hodiah Wilson, LPC
• Toccara Wilson
• Tonya Wajciechowski Wilson, M.ED, BCBA, LBA
• Whitney Cornesha Wilson, MSW

• Marriage & Family Therapist in Richmond, VA
• Providers in Richmond, VA by specialty
• Marriage & Family Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.