CHARLES JAY WILSON (NPI# 1750744678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750744678 |
| Entity Type | Individual |
| Full Name | CHARLES JAY WILSON |
| Credential | MA, PLPC |
| Practice Address |
711 N Market Ave Bolivar MO 65613-1114 |
| Practice Telephone | 4173991793 |
| Mailing Telephone | 4173991793 |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2016-03-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
2016008451 | MO | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538715305 | Charles Louis Wilson | Massage Therapist | 2900 Government St Ste A, Ocean Springs, MS 39564-5647 | 2019-08-16 |
| 1447770086 | Charles Lynn Wilson Jr. | Case Manager/Care Coordinator | 200 S Chambers Ave Lot 26, Claremore, OK 74017-5203 | 2017-06-25 |
| 1063838639 | Charles Lloyd Wilson | Hospitalist | Mercy South, 5200 E I-240 Service Road, Oklahoma City, OK 73135 | 2014-03-06 |
| 1114295896 | Charles Everett Wilson | Dermatology | 2211 Fernwood Ct, Grand Junction, CO 81506-6062 | 2011-12-08 |
| 1518249424 | Charles Christian Wilson IIi | Pharmacist | 3240 Ivory Coast Dr, Las Vegas, NV 89117-2269 | 2011-09-16 |
| 1497066518 | Charles Omar Wilson Jr. | Pathology | 175 Samaritan Way, Jasper, GA 30143 | 2010-06-23 |
| 1629399522 | Charles Brent Wilson | Dentist | 7689 Us Hwy 61, Saint Francisville, LA 70775-0820 | 2010-06-15 |
| 1376705434 | Charles Emmons Wilson | Marriage & Family Therapist | 511north 12th St, Riverton, WY 82501 | 2008-06-30 |
| 1598953184 | Charles Wilson | Physical Therapist | 43 Bowman Dr, Waynesville, NC 28785-6115 | 2007-10-09 |
| 1295933471 | Charles Richard Wilson | Surgery | 6 Woodland Rd Ste 205, Saint Helena, CA 94574-9501 | 2007-07-10 |
| Street Address |
711 N MARKET AVE |
| City | BOLIVAR |
| State | MO |
| Zip Code | 65613-1114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225690175 | New Way Psychological Services LLC | Counselor | 711 N Market Ave, Bolivar, MO 65613-1114 | 2019-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301552 | Casablanca Care Center, LLC | Home Health | 524 S. Albany Avenue, Bolivar, MO 65613 | 2020-09-18 |
| 1669087045 | Revive Medical LLC | Durable Medical Equipment & Medical Supplies | 5000, S Scenic, Bolivar, MO 65613 | 2020-09-11 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1932754744 | Caitlin M Williams | Specialist/Technologist | 1260 S Pike Avenue, Bolivar, MO 65613 | 2019-08-08 |
| 1073022406 | Jacquelyn Rose Kemnic | Dietitian, Registered | Heart Center, 1500 N Oakland Ave, Willard, MO 65613 | 2017-09-28 |
| 1164897161 | Ozarks Resource Group | Clinic/Center | 203 E. Broadway St., Bolivar, MO 65613 | 2015-12-02 |
| 1962895292 | Professional Christian Counseling | Counselor | 4888 S 139th Road, Bolivar, MO 65613 | 2015-03-11 |
| 1073916573 | Scott Leslie Dennis | Physician Assistant | 1500 North Oakland Ave, Citizens Memorial Hospital, Bolivar, MO 65613 | 2014-09-29 |
| 1053712109 | Citizens Memorial Hospital District | Pharmacy | 1301-b North Oakland, Bolivar, MO 65613 | 2014-09-09 |
| 1740680453 | Jamee M Stimpson | Occupational Therapist | 454 S. Main Avenue, Bolivar, MO 65613 | 2014-08-29 |
| Find all providers in zip 65613 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386285724 | Rebecca R Fetter | Counselor | 412 Shaffer Street, Bolivar, PA 15923 | 2019-10-07 |
| 1962895292 | Professional Christian Counseling | Counselor | 4888 S 139th Road, Bolivar, MO 65613 | 2015-03-11 |
| 1205261617 | Bethany Bair | Counselor | 1182 Bimeler St Ne, Bolivar, OH 44612-8665 | 2013-09-05 |
| 1770600165 | Debby Black | Counselor | 104 B. West Jackson Street, Bolivar, MO 65613 | 2007-03-23 |
| 1043336589 | Kelley White | Counselor | 104 W Jackson St, B, Bolivar, MO 65613-1902 | 2007-03-22 |
| 1245250091 | New Medico Healthcare Corporation | Counselor | 3361 S Springfield Ave, Bolivar, MO 65613-9132 | 2006-07-21 |
| 1750351409 | John Richard Spooner | Counselor | 2085 S Boston Pl, Bolivar, MO 65613-2871 | 2006-01-25 |
| 1225690175 | New Way Psychological Services LLC | Counselor | 711 N Market Ave, Bolivar, MO 65613-1114 | 2019-07-01 |
| 1902385040 | Erica Ruth Miller | Counselor | 1901 Wommack Ave, Bolivar, MO 65613-3128 | 2018-08-09 |
| 1801312459 | Southern Light Residential | Counselor | 1211 E Broadway St, Bolivar, MO 65613-2952 | 2017-08-16 |
| Find all providers in BOLIVAR | ||||
Please comment or provide details below to improve the information on CHARLES JAY 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.