| Wilson Counseling Llc | |
|
1312 Westen St Bowling Green KY 42104-3352 | |
| (270) 904-1072 | |
| (270) 904-1073 |
| Full Name | Wilson Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1312 Westen St, Bowling Green, Kentucky |
| Authorized Official Name and Position | Eddie R. Wilson (ADMINISTRATOR) |
| Authorized Official Contact | 2709041072 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilson Counseling Llc 1312 Westen St Bowling Green KY 42104-3352 Ph: (270) 904-1072 | Wilson Counseling Llc 1312 Westen St Bowling Green KY 42104-3352 Ph: (270) 904-1072 |
| NPI Number | 1427480060 |
|---|---|
| Provider Enumeration Date | 08/06/2013 |
| Last Update Date | 01/02/2024 |
| Certification Date | 01/02/2024 |
| Medicare PECOS PAC ID | 6608091079 |
|---|---|
| Medicare Enrollment ID | O20140627001883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427480060 | NPI | - | NPPES |
| 7100300070 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 3505 (Kentucky) | Primary |
| Provider Name | Kimberly Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255639431 PECOS PAC ID: 7416172887 Enrollment ID: I20140627001917 |
| Provider Name | Nicholas Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235612946 PECOS PAC ID: 8224432778 Enrollment ID: I20210805003476 |
| Provider Name | Hannah M Shaaban |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902466683 PECOS PAC ID: 1658778758 Enrollment ID: I20210915003883 |
| Provider Name | Emily Catherine Gaither |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093375693 PECOS PAC ID: 1557757887 Enrollment ID: I20220413000603 |
| Provider Name | Lauren Dorris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538801592 PECOS PAC ID: 3870956311 Enrollment ID: I20230830003382 |
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