THE WILSON HOUSE (NPI# 1134556897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134556897 |
| Entity Type | Organization |
| Organization Name | THE WILSON HOUSE |
| Practice Address |
1711 West Lakewood Ave. Durham NC 27707 |
| Mailing Address |
2331 Crownpoint Executive Drive Suite J Charlotte NC 28227 |
| Practice Telephone | 7048413544 |
| Practice Fax Number | 7048413545 |
| Mailing Telephone | 7048413544 |
| Mailing Fax Number | 7048413545 |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2017-05-26 |
| Authorized Official Name | KIERAN M DEAN (PRESIDENT, CFO) |
| Authorized Official Telephone | 7048413544 |
| Is Organization Subpart | Y |
| Parent Organization Name | UNITED SUPPORT SERVICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL-032-576 | NC | Residential Treatment Facilities |
| N | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3409493 | 05 |
| Street Address |
1711 WEST LAKEWOOD AVE. |
| City | DURHAM |
| State | NC |
| Zip Code | 27707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538785928 | Ceara Smith | Social Worker | 1415 W Nc 54 Buidling 200, Suite 111, Durham, NC 27707 | 2020-06-22 |
| 1114554094 | Lauren Michelle Grosse | Physician Assistant | Fastmed Urgent Care 7010 Nc-751, Durham, NC 27707 | 2020-03-23 |
| 1386289635 | Ashley Bailey | Counselor | 1801 Fayetteville Street, Durham, NC 27707 | 2019-11-11 |
| 1881249886 | Erin Ramona Leger | Physical Therapist | 3706 Mayfair St, Ste 120, Durham, NC 27707 | 2019-08-06 |
| 1417417262 | Carmen Elisabeth Sanchez | Psychologist | 3326 Durham Chapel Hill Blvd Bldg D, Durham, NC 27707 | 2019-03-20 |
| 1477026144 | Pope Behavioral Health and Wellness | Counselor | 5102 Chapel Hill Durham Blvd., Suite 101, Durham, NC 27707 | 2019-01-06 |
| 1043780778 | Jessica Ann Revels | Counselor | 1415 West North Carolina 54, Building 100 Suite # 204, Durham, NC 27707 | 2018-11-26 |
| 1558830125 | Michael Brown | Counselor | 1502 W Nc-54, Suite 505, Durham, NC 27707 | 2018-11-13 |
| 1780152827 | Cassandra Gerwig Shaw | Registered Nurse | 5324 Mcfarland Dr Ste 310, Durham, NC 27707 | 2018-11-07 |
| 1942776232 | Lisa J Keskitalo | Physical Therapist | 3708 Mayfair St Ste 120, Durham, NC 27707 | 2018-10-15 |
| Find all providers in zip 27707 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417578667 | Alternative Choice Home Care Agency, LLC | Community/Behavioral Health | 800 N Mangum St Ste A-i, Durham, NC 27701-2260 | 2020-04-29 |
| 1316589138 | Monarch | Community/Behavioral Health | 1513 Piperwood Court, Durham, NC 27713 | 2019-10-14 |
| 1457916132 | Kalvin Franklin Jr. | Community/Behavioral Health | 2632 Cherry Creek Dr, Durham, NC 27703-5746 | 2019-05-07 |
| 1356804108 | Komkare Empowerment Center | Community/Behavioral Health | 1058 W Club Blvd Ste 232, Durham, NC 27701-1149 | 2019-04-09 |
| 1952883431 | Willow Oak Therapy, Pllc | Community/Behavioral Health | 3622 Lyckan Pkwy Ste 6006, Durham, NC 27707-2539 | 2018-08-31 |
| 1033634886 | Liasions Community Care | Community/Behavioral Health | 304a N Driver St, Durham, NC 27703-3058 | 2017-08-12 |
| 1447785134 | Nathaniel David Sawyer | Community/Behavioral Health | 5731 N Roxboro Rd, Durham, NC 27712-1427 | 2017-05-01 |
| 1376075556 | Baart Community Healthcare | Community/Behavioral Health | 800 N Mangum St Ste 300&400, Durham, NC 27701-2260 | 2017-03-28 |
| 1457807968 | Therapeutic Interventions Pllc | Community/Behavioral Health | 1058 W Club Blvd Ste 602, Durham, NC 27701-1159 | 2016-08-25 |
| 1912355298 | Harmony Healthcare Services, LLC | Community/Behavioral Health | 4004 Ben Franklin Blvd Ste C, Durham, NC 27704-2384 | 2016-05-27 |
| Find all providers in DURHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.