SHANTA NICOLE WILSON (NPI# 1467989806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467989806 |
| Entity Type | Individual |
| Full Name | SHANTA NICOLE WILSON |
| Credential | LPC, LPC-MHSP, NCC |
| Practice Address |
868 N Manassas St Memphis TN 38107-2516 |
| Mailing Address |
8787 Legacy Dr Apt 1480 Frisco TX 75034-2545 |
| Practice Telephone | 9015772500 |
| Mailing Telephone | 9012184688 |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2020-06-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
80044 | TX | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
3708 | TN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700370764 | Shanta Rena Wilson | Case Manager/Care Coordinator | 128 Louisiana Ave, Ferriday, LA 71334-2826 | 2018-06-21 |
| Street Address |
868 N MANASSAS ST |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38107-2516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447536875 | Children's Bureau Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 868 N Manassas St, Memphis, TN 38107-2516 | 2011-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346801925 | Sarah E. Stevenson | Respiratory Therapist, Certified | 236 Caldwell Ave., Memphis, TN 38107 | 2019-06-25 |
| 1235516097 | Behavioral Healthcare Center At Memphis, Inc. | Psychiatric Hospital | 1505 N Second Street, Memphis, TN 38107 | 2015-04-30 |
| 1568732766 | Mary Geneva Scott | Pharmacist | 957 Elm Grove Cr, Collierville, TN 38107 | 2012-01-04 |
| 1053375634 | Harbor View Nursing and Rehabilitation Center Inc | Nursing Facility/Intermediate Care Facility | 1513 N 2nd St, Memphis, TN 38107 | 2006-04-12 |
| 1902289937 | Emily Williams | Speech-Language Pathologist | 1513 N 2nd St, Memphis, TN 38107-1003 | 2015-07-08 |
| 1043586498 | Jordan A Bunn | Occupational Therapist | 1513 N 2nd St, Memphis, TN 38107-1003 | 2012-03-30 |
| 1700186624 | Colleen M. Foeller | Occupational Therapy Assistant | 1513 N 2nd St, Memphis, TN 38107-1003 | 2010-10-26 |
| 1972818920 | Brian Matthew Defeo | Physical Therapist | 1513 N 2nd St, Memphis, TN 38107-1003 | 2010-08-15 |
| 1154635993 | Jonna Pfountz | Occupational Therapist | 1513 N 2nd St, Memphis, TN 38107-1003 | 2010-08-04 |
| 1891009643 | Montricia Renese Glenn | Occupational Therapist | 1513 N 2nd St, Memphis, TN 38107-1003 | 2010-08-04 |
| Find all providers in zip 38107 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748854 | Kristen Hoover | Counselor | 4515 Poplar Ave Ste 305, Memphis, TN 38117-7507 | 2020-10-26 |
| 1609473966 | Ashley N. Thomas | Counselor | 4189 Robert Everett Cv Apt 2, Memphis, TN 38111-7437 | 2020-10-08 |
| 1952918617 | Kate Mallory | Counselor | 240 Madison Ave Ste 601, Memphis, TN 38103-2770 | 2020-09-28 |
| 1174134597 | James Rogers | Counselor | 100 Ball Hall, Memphis, TN 38152-3502 | 2020-08-10 |
| 1952911455 | Brianna Amaba | Counselor | 3675 Alumni Ave, Memphis, TN 38152-0001 | 2020-08-09 |
| 1164032645 | Lauren Taylor Riddick | Counselor | 1957 Jefferson Ave, Memphis, TN 38104-2705 | 2020-08-09 |
| 1063022671 | Sedaria L Williams | Counselor | 1242 Woodbury St, Memphis, TN 38111-3944 | 2020-08-07 |
| 1437768264 | Rebecca Mclaurin Maddux | Counselor | 4937 William Arnold Rd, Memphis, TN 38117-4237 | 2020-07-28 |
| 1578181780 | Jacqueline Yvette Reid | Counselor | 2924 Walnut Grove Rd Ste 4, Memphis, TN 38111-2719 | 2020-07-14 |
| 1225653876 | Michelle Leigh Cooper | Counselor | 1255 Lynnfield St Ste 232, Memphis, TN 38119-5185 | 2020-06-09 |
| Find all providers in MEMPHIS | ||||
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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.