MR. DEREK JAMES WILSON (NPI# 1114348729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114348729 |
| Entity Type | Individual |
| Full Name | MR. DEREK JAMES WILSON |
| Credential | LPC |
| Practice Address |
360 Bloomfield Ave Ste 301 Windsor CT 06095-2700 |
| Mailing Address |
260 Carriage Crossing Ln Middletown CT 06457-5864 |
| Practice Telephone | 8604713819 |
| Mailing Telephone | 8604713819 |
| Enumeration Date | 2013-12-27 |
| Last Update Date | 2018-10-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
003206 | CT | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 50 Brookside Rd, Waterbury, CT 067081402 | 2037554490 | 2035738053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134640741 | Derek James Wilson | Pharmacist | 2a Walter E Foran Blvd, Flemington, NJ 08822 | 2017-07-05 |
| 1093143950 | Derek Wilson | Counselor | 204 S Irwin Ave, Charlotte, NC 28202-1117 | 2013-10-30 |
| 1043829302 | Derek Alan Wilson | Developmental Therapist | 4160 Piedmont Pkwy Ste 207, Greensboro, NC 27410-8174 | 2020-07-23 |
| 1841668035 | Derek Timothy Wilson | Nurse Anesthetist, Certified Registered | 907 E Lamar Alexander Pkwy, Maryville, TN 37804-5015 | 2015-09-04 |
| 1558760132 | Derek James Wilson | Physician Assistant | 1600 Sw Archer Rd, Gainesville, FL 32610-0371 | 2014-08-19 |
| 1417034026 | Derek Edward Wilson | Physician Assistant | 800 W Laurel St, Independence, KS 67301-3211 | 2006-11-01 |
| Street Address |
360 BLOOMFIELD AVE STE 301 |
| City | WINDSOR |
| State | CT |
| Zip Code | 06095-2700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043533557 | Joyce A Erickson | Counselor | 360 Bloomfield Ave Ste 301, Windsor, CT 06095-2700 | 2010-03-11 |
| 1306446190 | Norma Joy B-mullings | Counselor | 360 Bloomfield Ave Ste 301, Windsor, CT 06095-2700 | 2020-10-29 |
| 1437759420 | Charlotte Zocco | Behavior Technician | 360 Bloomfield Ave Ste 301, Windsor, CT 06095-2700 | 2020-10-28 |
| 1326646316 | Julia Danielle Frey | Behavior Technician | 360 Bloomfield Ave Ste 301, Windsor, CT 06095-2700 | 2020-10-13 |
| 1659987345 | Lauren Oates | Behavior Technician | 360 Bloomfield Ave Ste 301, Windsor, CT 06095-2700 | 2020-09-18 |
| 1568076131 | Jolyn Wayne | Behavior Technician | 360 Bloomfield Ave Ste 301, Windsor, CT 06095-2700 | 2020-09-01 |
| 1821600669 | Olivia Motherway | Behavior Technician | 360 Bloomfield Ave Ste 301, Windsor, CT 06095-2700 | 2020-08-22 |
| 1396357331 | Radiant Life Psychotherapy LLC | Counselor | 360 Bloomfield Ave Ste 301, Windsor, CT 06095-2700 | 2020-08-20 |
| 1942812839 | Sharon Rosemarie Clato-day | Social Worker | 360 Bloomfield Ave Ste 301, Windsor, CT 06095-2700 | 2020-08-20 |
| 1144839721 | Grace Ege | Behavior Technician | 360 Bloomfield Ave Ste 301, Windsor, CT 06095-2700 | 2020-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285255992 | Dnd Group of Companies LLC | Psychologist | 204 Old Village Cir, Windsor, CT 06095 | 2020-05-04 |
| 1811467442 | Joseph C Gaetani Jr. | Specialist | 340 Broad Street Suite 320, Windsor, CT 06095 | 2018-11-27 |
| 1447629043 | Brittany Higginbotham | Marriage & Family Therapist | 347 Park Avenue, Windsor, CT 06095 | 2015-09-24 |
| 1457737454 | Eric Han | Dentist | 697 Poquonock Ave, Windsor, CT 06095 | 2015-08-03 |
| 1265780894 | Annetta Ruth Troche | Nurse Practitioner | 22 Parkwood Drive, Windsor, CT 06095 | 2012-08-29 |
| 1821234006 | Milna Rosario | Social Worker | 6 Poquonock Avenue, Windsor, CT 06095 | 2008-12-18 |
| 1962686824 | Kimberly Ju Kim | Pediatrics | 820 C Prospect Hill Road, Windsor, CT 06095 | 2007-12-27 |
| 1972708758 | Price Chopper Inc | Pharmacy | 675 Poquoncock Ave, Windsor, CT 06095 | 2007-06-20 |
| 1396870358 | Occupational Health Centers of The Southwest, P.a., P.C. | Clinic/Center | 1080 Day Hill Road, Windsor, CT 06095 | 2007-02-22 |
| 1841342094 | Thomas F. Reif | Psychologist | 32 Maple Avenue, Windsor, CT 06095 | 2007-01-17 |
| Find all providers in zip 06095 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518576040 | Carolyn Mae Mader | Counselor | 2025 Bayfront Ct, Windsor, CO 80550-3592 | 2020-07-30 |
| 1578197349 | Heather M Burkey-skye | Counselor | 1223 Fairfield Ave, Windsor, CO 80550-5822 | 2020-03-02 |
| 1427680933 | Kelli Price | Counselor | 15 Berrios Hill Rd, Windsor, CT 06095-1000 | 2020-02-12 |
| 1427694546 | Gerard Fitzgerald | Counselor | 303 Coopers Mills Rd, Windsor, ME 04363-3825 | 2019-11-24 |
| 1518492297 | Jason Allen | Counselor | 602 Park Edge Cir, Windsor, CO 80550-3255 | 2017-05-01 |
| 1932553567 | Samantha Sanborn | Counselor | 55 Poquonock Ave, Windsor, CT 06095-2508 | 2016-04-20 |
| 1114316544 | Rosanna Z Wilson | Counselor | 1 Kellogg St, Windsor, CT 06095-3117 | 2015-01-22 |
| 1043533557 | Joyce A Erickson | Counselor | 360 Bloomfield Ave Ste 301, Windsor, CT 06095-2700 | 2010-03-11 |
| 1689792582 | Heather Findlay | Counselor | 841 Us Route 5 N, Windsor, VT 05089-9693 | 2007-03-27 |
| 1871600619 | Allisyn Hollweg | Counselor | 1170 W Ash St Ste 100, Windsor, CO 80550-4783 | 2006-08-25 |
| Find all providers in WINDSOR | ||||
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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.