DR. CORLISSA J WILSON (NPI# 1033732946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033732946 |
| Entity Type | Individual |
| Full Name | DR. CORLISSA J WILSON |
| Credential | ED.D, LPC, NCC, NCSC |
| Practice Address |
3217 Warren Creek Dr Powder Springs GA 30127-9044 |
| Practice Telephone | 4044353388 |
| Mailing Telephone | 4044353388 |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2020-05-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
002236 | GA | Behavioral Health & Social Service Providers |
| Street Address |
3217 WARREN CREEK DR |
| City | POWDER SPRINGS |
| State | GA |
| Zip Code | 30127-9044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922580935 | Judette Barthelemy | Nurse Practitioner | 5280 Jones Reserve Walk, Powder Springs, GA 30127 | 2018-09-06 |
| 1174049837 | Patricia Anderson | Home Health Aide | 4089 Sweetsprings Terrace Southwest, Powder Springs, GA 30127 | 2017-08-15 |
| 1972028777 | Jonathan J Jones Jr. | Technician | 4089 Sweetsprings Terrace Sw, Powder Springs, GA 30127 | 2017-08-14 |
| 1124575279 | Thomas Jones | Private Vehicle | 3271 Barnwell Trce, Powder Springs, GA 30127 | 2016-09-07 |
| 1194184598 | Francesca Momplaisir | Chiropractor | 4851 Saddlerun Ln, Powder Springs, GA 30127 | 2016-02-15 |
| 1639535073 | Yonide Lareche | Nurse Practitioner | 184 Windriver Trik, Powderspring, GA 30127 | 2016-01-14 |
| 1740607035 | Health Star Home Health Care LLC | Home Health | 2148 Chaseford Ln, Powder Springs, GA 30127 | 2014-03-25 |
| 1073850855 | Charles Cordaro | Pharmacist | 2000 East West Connector, Health Services Center, 1st Floor - Pharmacy, Austell, GA 30127 | 2013-01-14 |
| 1669748539 | Scott Gynecology & Pelvic Surgery, P.C. | Obstetrics & Gynecology | 5041 Dallas Highway, Building 1, Suite G, Powder Springs, GA 30127 | 2012-03-26 |
| 1265706576 | Danielle Olivier Mental Health Services | Community/Behavioral Health | 3468 Hollow Stream Trail, Powder Prings, GA 30127 | 2012-03-05 |
| Find all providers in zip 30127 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841726304 | Joseph Ryan Humphries | Counselor | 4196 Oak Springs Rd, Powder Springs, GA 30127-3907 | 2017-05-03 |
| 1336296847 | Robert John Jacobs | Counselor | 2378 Scotney Castle Ln, Powder Springs, GA 30127-5900 | 2007-01-05 |
| 1629464839 | Brittany Osborne | Counselor | 5041 Dallas Hwy Ste 402, Powder Springs, GA 30127 | 2015-04-14 |
| 1811147366 | Carol L. Moore | Counselor | 5041 Dallas Hwy, 700, Powder Springs, GA 30127-6458 | 2008-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780859 | Jennifer Lynn Fedderick | Counselor | 459 Thrasher Rd, Plains, GA 31780-5310 | 2020-11-04 |
| 1376144766 | Arlicia Lagene Johnson | Counselor | 220 Osmanthus Way, Canton, GA 30114-7197 | 2020-11-03 |
| 1558962027 | Evan Kauper | Counselor | 2002 Smith Dr Nw, Kennesaw, GA 30144-1851 | 2020-11-02 |
| 1801496864 | Poonam A Patel | Counselor | 2916 Clairmont Rd Ne Apt 2413, Brookhaven, GA 30329-4476 | 2020-10-29 |
| 1740880061 | Pledger Behavior Consulting, LLC | Counselor | 7563 Highway 337, Summerville, GA 30747-6101 | 2020-10-27 |
| 1801495411 | Bianca Tiara Abrams | Counselor | 916 Glenwood Park Dr Se, Atlanta, GA 30316-6845 | 2020-10-23 |
| 1780283713 | Stacey Dougan | Counselor | 696 Mountain Dr Ne, Atlanta, GA 30342-3904 | 2020-10-21 |
| 1619576865 | Therapy Pond, LLC | Counselor | 1262 Concord Rd Se Ste 200, Smyrna, GA 30080-5307 | 2020-10-20 |
| 1164021259 | Miracles Outreach International | Counselor | 6825 Jimmy Carter Blvd Ste 1570b, Norcross, GA 30071-1215 | 2020-10-20 |
| 1699374025 | Alexxis Trimmings | Counselor | 205 W Montgomery Xrd Apt 106, Savannah, GA 31406-7121 | 2020-10-17 |
| Find all providers with the same taxonomy | ||||
| City | POWDER SPRINGS |
| Zip Code | 30127 |
Please comment or provide details below to improve the information on DR. CORLISSA J 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.