TINA WILSON (NPI# 1033653720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033653720 |
| Entity Type | Individual |
| Full Name | TINA WILSON |
| Practice Address |
139 Whippoorwill Ln Mt Holly NC 28120-9761 |
| Mailing Address |
205 Whippoorwill Ln Mt Holly NC 28120-9761 |
| Practice Telephone | 7045741549 |
| Mailing Telephone | 7045741549 |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2017-08-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | MHL-036-323 | NC | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497295067 | Tina Wilson | Counselor | 591 State Route 244, Alfred Station, NY 14803 | 2017-03-02 |
| 1417262205 | Tina Wilson | Mechanotherapist | 15019 Nw 5th Ave, Newberry, FL 32669-2828 | 2010-08-17 |
| 1003442690 | Tina Wilson | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2020-03-16 |
| 1548696388 | Tina Andrea Wilson | Counselor | 8430 University Exec Park Dr, Ste. 655, Charlotte, NC 28262-1350 | 2013-09-25 |
| 1902158348 | Tina Wilson | Hearing Instrument Specialist | 1801 S State Road 57, Washington, IN 47501-4326 | 2012-10-10 |
| 1376579854 | Tina Wilson | Internal Medicine | 620 Skyline Dr, Jackson, TN 38301 | 2006-06-25 |
| 1770551319 | Tina L Wilson | Registered Nurse | 580 Westport Rd, Elizabethtown, KY 42701-2949 | 2006-03-09 |
| 1548262058 | Tina Louise Wilson | Pharmacist | 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342-1606 | 2005-08-15 |
| Street Address |
139 WHIPPOORWILL LN |
| City | MT HOLLY |
| State | NC |
| Zip Code | 28120-9761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851775027 | Wesley Marsh | Dentist | 176 Palomino Trl, Mt Holly, NC 28120 | 2015-07-16 |
| 1407094642 | Kelly Lee Coney Pacious | Physical Therapist | 328 Whippoorwill Lane, Mount Holly, NC 28120 | 2009-01-26 |
| 1427183979 | Touched By Angels Home Healthcare, Inc. | Home Health | 16 Oak Grove St, Mt Holly, NC 28120 | 2007-02-23 |
| 1417052119 | Andrew Rogers Oblinger | Dentist | 247 W Catawba Ave, Mt Holly, NC 28120 | 2006-09-14 |
| 1437648334 | Moose Pharmacy of Mt Holly LLC | Durable Medical Equipment & Medical Supplies | 125 W Central Ave, Mount Holly, NC 28120 | 2018-05-07 |
| 1104898634 | Michael Alson Smith | Family Medicine | 305 W Catawba Ave, Mount Holly, NC 28120 | 2006-02-07 |
| 1972642049 | Woodlawn Haven, Inc | Assisted Living Facility | 301 Craig St, Mount Holly, NC 28120-1265 | 2007-02-06 |
| 1306455126 | A Place 4 Me, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5305 Clearwater Lake Rd, Mount Holly, NC 28120-1445 | 2020-07-28 |
| 1487946380 | Monica K Rendon | Specialist | 320 Langhorne Dr, Mt Holly, NC 28120-1452 | 2011-05-10 |
| 1033750674 | Amanda Marie Antczak | Counselor | 129 Maggie Dr, Mount Holly, NC 28120-1486 | 2019-10-04 |
| Find all providers in zip 28120 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041667 | Jalisa Jackson | Community Based Residential Treatment Facility, Mental Illness | 11413 Mangla Dr, Charlotte, NC 28214-8885 | 2020-10-19 |
| 1245837061 | Bliss Haven Group LLC | Community Based Residential Treatment Facility, Mental Illness | 2442 Sandhurst Ct, Gastonia, NC 28054-2738 | 2020-10-05 |
| 1386259265 | Nevaehs Caring Hands | Community Based Residential Treatment Facility, Mental Illness | 2509 Dalton Rd, Rocky Mount, NC 27803-4721 | 2020-09-09 |
| 1588279442 | C & C Homecare, LLC | Community Based Residential Treatment Facility, Mental Illness | 5119 Holdens Cross Rd, Wilson, NC 27893-8253 | 2020-09-08 |
| 1801409859 | Destiny & Miracle LLC | Community Based Residential Treatment Facility, Mental Illness | 1024 Houston St, Gastonia, NC 28052-1632 | 2020-08-28 |
| 1699329433 | Fresh Start Today Inc | Community Based Residential Treatment Facility, Mental Illness | 3707 Roseheim Ct, Greensboro, NC 27405-4867 | 2019-07-30 |
| 1003460833 | Care-in-full | Community Based Residential Treatment Facility, Mental Illness | 1338 Sharp Ridge Rd, Greensboro, NC 27406-8597 | 2019-07-30 |
| 1366001976 | Foundation of Hope, Inc. | Community Based Residential Treatment Facility, Mental Illness | 119 Grice Road, Chadbourn, NC 28431-6709 | 2019-06-07 |
| 1558927590 | Tall Family Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1915 Hasty Rd, Marshville, NC 28103-0029 | 2019-05-15 |
| 1174187868 | Stepping Stone Services Inc. | Community Based Residential Treatment Facility, Mental Illness | 2720 White Oak Ln, Kannapolis, NC 28083-7256 | 2019-04-28 |
| Find all providers with the same taxonomy | ||||
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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.