Charlie Isiah Wilson Jr, in Conway, SC - Medicare Counselor Provider

Charlie Isiah Wilson Jr, is a medicare enrolled "Counselor - Professional" provider in Conway, South Carolina. His current practice location is 164 Waccamaw Medical Park Dr, Conway, South Carolina. You can reach out to his office (for appointments etc.) via phone at (843) 347-5060.

Charlie Isiah Wilson Jr is licensed to practice in South Carolina (license number 8742) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1538635115.

Contact Information

	Charlie Isiah Wilson Jr,
	164 Waccamaw Medical Park Dr, Conway, SC 29526-8903
	(843) 347-5060
	(843) 347-3959

Map and Direction

Healthcare Provider's Profile

Full Name	Charlie Isiah Wilson Jr
Gender	Male
Speciality	Counselor - Professional
Location	164 Waccamaw Medical Park Dr, Conway, South Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1538635115
Provider Enumeration Date: 10/22/2018
Last Update Date: 10/10/2024

Medicare PECOS Information:

PECOS PAC ID: 7911422605
Enrollment ID: I20250415002417

Medical Identifiers

Medical identifiers for Charlie Isiah Wilson Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1538635115	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	8742 (South Carolina)	Primary
101YM0800X	Counselor - Mental Health	8742 (South Carolina)	Secondary
101YM0800X	Counselor - Mental Health	(* (Not Available))	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Charlie Isiah Wilson Jr allows following entities to bill medicare on his behalf.

Entity Name	Mental Health Specialty Group Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1801472634 PECOS PAC ID: 8921466228 Enrollment ID: O20240926003314

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Charlie Isiah Wilson Jr is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Charlie Isiah Wilson Jr, 164 Waccamaw Medical Park Dr, Conway, SC 29526-8903 Ph: (843) 347-5060	Charlie Isiah Wilson Jr, 164 Waccamaw Medical Park Dr, Conway, SC 29526-8903 Ph: (843) 347-5060

Reviews and Comments

Counselor in Conway, SC

Ms. Tawan Binnetta Alston, Counselor Medicare: Not Enrolled in Medicare Practice Location: 164 Waccamaw Medical Park Dr, Conway, SC 29526 Phone: 843-347-5060
Latoya Lawrence, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2404 Wise Rd, Conway, SC 29526 Phone: 843-365-8884
Sabrina Jelks, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 2404 Wise Rd, Conway, SC 29526 Phone: 843-365-8884
Hanna Grace Hardee, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2404 Wise Rd, Conway, SC 29526 Phone: 843-365-8884
Jannie Lance Morant, Counselor Medicare: Not Enrolled in Medicare Practice Location: 164 Waccamaw Medical Park Dr, Conway, SC 29526 Phone: 843-347-5060
Joseph E Dekine, Counselor Medicare: Not Enrolled in Medicare Practice Location: 164 Waccamaw Medical Park Dr, Conway, SC 29526 Phone: 843-347-5060
Susan Ann Mclean, LPC, NCC, CCH Counselor Medicare: Not Enrolled in Medicare Practice Location: 172 Waccamaw Medical Park Ct, Conway, SC 29526 Phone: 843-457-0946

Charlie Isiah Wilson Jr, - Medicare Counselor in Conway, SC