SHANE RAY WILSON (NPI# 1063742138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063742138 |
| Entity Type | Individual |
| Full Name | SHANE RAY WILSON |
| Credential | LPC,LADC |
| Practice Address |
2820 Weymouth Way Norman OK 73071-7269 |
| Practice Telephone | 4054749374 |
| Practice Fax Number | 4057015843 |
| Mailing Telephone | 4054749374 |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2010-01-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
135 | OK | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
2179 | OK | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669952966 | Shane Wilson | Non-emergency Medical Transport (VAN) | 1522 S Tyler St, Little Rock, AR 72204 | 2018-08-16 |
| 1982009569 | Shane Michael Wilson | Chiropractor | 938 Wrens Roost Cir, 2, Memphis, TN 38119-0510 | 2014-10-25 |
| 1902440035 | Shane Marcus Wilson | Physical Therapy Assistant | 10600 Mastin St, Overland Park, KS 66212-5723 | 2019-11-01 |
| 1437624236 | Shane David Wilson | Nurse Practitioner | 1249 15th St Ste 4000, Huntington, WV 25701-3663 | 2018-10-08 |
| 1477808467 | Shane Charles Wilson | Internal Medicine | 450 E Sigler Ave, Ste A, Memphis, MO 63555-1726 | 2012-07-17 |
| 1245548239 | Shane Wilson | Rehabilitation Practitioner | 741 Rancho Via Dr, Sparks, NV 89434-4051 | 2010-09-23 |
| 1336314392 | Shane Wilson | Counselor | 1470 W Herndon Ave, Suite 300, Fresno, CA 93711-0552 | 2008-04-29 |
| Street Address |
2820 WEYMOUTH WAY |
| City | NORMAN |
| State | OK |
| Zip Code | 73071-7269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952913741 | Jeanne Marie Tomlinson | Occupational Therapist | 2701 Weymouth Way, Norman, OK 73071 | 2020-08-21 |
| 1780215947 | Denise Kay Kliewer | Occupational Therapy Assistant | 1412 Spoonwood Dr, Norman, OK 73071 | 2020-01-27 |
| 1689182511 | Eric Melvin Green | Case Manager/Care Coordinator | 2038 24th Ave. Se, Norman, OK 73071 | 2018-01-12 |
| 1841726320 | Summer Dental Norman | Dentist | 1240 Alameda St., Norman, OK 73071 | 2017-05-03 |
| 1336503606 | Full Circle Adult Day Center, Inc | Clinic/Center | 1304 E. Lindsey Plaza Drive, Norman, OK 73071 | 2016-04-12 |
| 1538524616 | Ashley White | Case Manager/Care Coordinator | 805 East Robinson, Norman, OK 73071 | 2015-12-16 |
| 1396119111 | Joseph Fleming Pllc | Dentist | 1515 E. Rock Creek Road, Suite 140, Norman, OK 73071 | 2015-11-17 |
| 1881025104 | Jill Blayney | Counselor | 909 Alameda, # 2607, Norman, OK 73071 | 2013-12-12 |
| 1578800504 | Cherie Albert | Counselor | 900 E Alameda, Norman, OK 73071 | 2013-01-10 |
| 1437430618 | Rose Rock Dental Pllc | Dentist | 1049 12th Ave. Ne, Suite 100, Norman, OK 73071 | 2011-09-01 |
| Find all providers in zip 73071 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396369286 | Advocate for Mental Health Services LLC | Counselor | 1300 Mcgee Dr Ste 103, Norman, OK 73072-5858 | 2020-06-05 |
| 1639791221 | Santa Gladys Velez | Counselor | 1215 Crossroads Blvd Ste 212, Norman, OK 73072-3391 | 2020-05-18 |
| 1881240372 | Cindy Joelle Owen | Counselor | 3625 W Main St Ste 100, Norman, OK 73072-4644 | 2019-08-12 |
| 1063931509 | Nicole Barlow | Counselor | 521 Sandpiper Ln, Norman, OK 73071-6182 | 2017-09-15 |
| 1689190852 | Worster Williams Counseling Pllc | Counselor | 2500 Mcgee Dr Ste 120, Norman, OK 73072-6705 | 2017-08-18 |
| 1407387491 | Cindy Holden | Counselor | 4101 Wood Castle St, Norman, OK 73072-1739 | 2017-03-22 |
| 1023562287 | Holly Carmen | Counselor | 4542 Steeplechase Dr, Norman, OK 73072-2861 | 2016-08-05 |
| 1942659727 | Kim Oliver | Counselor | 2807 Castlewood Dr, Norman, OK 73072-7526 | 2016-06-13 |
| 1528425212 | Mark Anthony Dominguez | Counselor | 3825 24th Ave Se, Apt. #5, Norman, OK 73071-1770 | 2016-01-26 |
| 1497147458 | Rhonda Burton Snodgrass | Counselor | 1618 Brookhaven Blvd, Norman, OK 73072-3208 | 2015-02-28 |
| Find all providers in NORMAN | ||||
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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.