MR. TYROLIA DEJUAN WILSON (NPI# 1588194450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588194450 |
| Entity Type | Individual |
| Full Name | MR. TYROLIA DEJUAN WILSON |
| Practice Address |
1121 N 5th St Kansas City KS 66101-2305 |
| Mailing Address |
509 E Elm St Salina KS 67401-2353 |
| Practice Telephone | 9138312820 |
| Practice Fax Number | 9138310262 |
| Mailing Telephone | 7858250541 |
| Mailing Fax Number | 7858250062 |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2017-06-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
949 | KS | Behavioral Health & Social Service Providers |
| Street Address |
1121 N 5TH ST |
| City | KANSAS CITY |
| State | KS |
| Zip Code | 66101-2305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003311069 | Francisco Torres-gonzalez | Counselor | 1121 N 5th St, Kansas City, KS 66101-2305 | 2018-03-29 |
| 1851813968 | Godswill Okorafor Chuku | Counselor | 1121 N 5th St, Kansas City, KS 66101-2305 | 2017-07-10 |
| 1831582097 | Debra Terrell Mckenzie | Counselor | 1121 N 5th St, Kansas City, KS 66101-2305 | 2015-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558984336 | Nicole Konrade | Occupational Therapist | 818 Ann Ave, Kansas City, KS 66101 | 2020-05-27 |
| 1639675119 | Teah Rae Strickland | Private Vehicle | 2103 N 7th St, Kansas City, KS 66101 | 2018-04-03 |
| 1629320320 | Elizabeth Jane Johnson | Speech-Language Pathologist | 1119 N. 5th St., Kansas City, KS 66101 | 2012-10-05 |
| 1720118110 | Promohispano Inc. | Technician/Technologist | 825 N 7th St, Suite 101, Kansas City, KS 66101 | 2007-03-06 |
| 1811042534 | Sunflower Adult Daycare Inc | Clinic/Center | 1109 N 5th, Kansas City, KS 66101 | 2007-01-24 |
| 1730178195 | Joe M. Herrera | Dentist | 701 Washington Blvd., Kansas City, KS 66101 | 2005-10-18 |
| 1558723031 | Garnetta King | Counselor | 803 Armstrong Ave, Associated Youth Services, Kansas City, KS 66101 | 2016-03-24 |
| 1447666110 | Jill Denise Coleman | Registered Nurse | 619 Ann Ave, Kansas City, KS 66101 | 2014-07-02 |
| 1629313192 | Leslie Marie Layton | Chiropractor | 300 N 7th St, Kansas City, KS 66101 | 2012-12-10 |
| 1457735185 | Jamie Adams | Registered Nurse | 924 Manorcrest Dr, Kansas City, KS 66101-1139 | 2015-07-13 |
| Find all providers in zip 66101 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356816631 | Patrick P Pruitt | Counselor | 600 W 39th St, Kansas City, MO 64111-2910 | 2018-10-12 |
| 1174989248 | Gary Dumas | Counselor | 1734 E 63rd St Ste 600b, Kansas City, MO 64110-5359 | 2016-01-05 |
| 1144690223 | Christy Pease | Counselor | 6723 State Ave, Kansas City, KS 66102-3020 | 2015-10-01 |
| 1598157380 | Nancy Mccormick | Counselor | 12 E Dartmouth Rd, Kansas City, MO 64113-2525 | 2015-03-03 |
| 1629485974 | Addiction Stress Center | Counselor | 1225 N 78th St, Suite J, Kansas City, KS 66112-2401 | 2014-07-18 |
| 1902210834 | Jessica Smith | Counselor | 1024 Hoel Pkwy, Kansas City, KS 66102-4138 | 2014-06-18 |
| 1114351053 | Falicia R Hooks | Counselor | 723 E 18th St, Kansas City, MO 64108-1511 | 2013-08-28 |
| 1922430909 | Erin Linne Gaal | Counselor | 4311 N 110th Ter, Kansas City, KS 66109-3603 | 2013-08-01 |
| 1861745382 | Tracie Lynn Camlin | Counselor | 630 Minnesota Ave Ste 204, Kansas City, KS 66101-2850 | 2012-10-22 |
| 1134487689 | Menissa Hill-brox | Counselor | 7933 State Ave, Suite 203, Kansas City, KS 66112-2468 | 2012-05-02 |
| Find all providers in KANSAS CITY | ||||
| City | KANSAS CITY |
| Zip Code | 66101 |
Please comment or provide details below to improve the information on MR. TYROLIA DEJUAN WILSON.
| 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.