TIA WILSON (NPI# 1245662832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245662832 |
| Entity Type | Individual |
| Full Name | TIA WILSON |
| Credential | LMHC |
| Practice Address |
1726 Kingsley Ave Orange Park FL 32073 |
| Mailing Address |
552 Ryker Way Orange Park FL 32065-8218 |
| Practice Telephone | 9042785659 |
| Mailing Telephone | 9048871121 |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2018-06-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH12025 | FL | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
IMH6626 | FL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3292 County Road 220, Middleburg, FL 320684357 | 9048871121 | 9042915575 |
| 4203 Southpoint Blvd, Jacksonville, FL 322166164 | 9042961055 | 9042961953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255709564 | Tia Lynn Wilson | Social Worker | 121 E Washington Ave, Unit Ll, Kirkwood, MO 63122-4481 | 2015-09-03 |
| Street Address |
1726 KINGSLEY AVE |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154303410 | Susan M Shepherd | Social Worker | 1726 Kingsley Ave, Ste 3, Orange Park, FL 32073-4463 | 2005-11-14 |
| 1740892355 | Allison Tharaldsen | Case Manager/Care Coordinator | 1726 Kingsley Ave, Orange Park, FL 32073-4463 | 2020-08-17 |
| 1376887315 | Ronny W Stephens | Counselor | 1726 Kingsley Ave, Suite 2, Orange Park, FL 32073-4463 | 2012-11-15 |
| 1427353150 | Janet M Grim Ma Lmft | Marriage & Family Therapist | 1726 Kingsley Ave, Suite 3, Orange Park, FL 32073 | 2011-01-11 |
| 1134276140 | J Nicholas Prewett Phd & Associates Pa | Counselor | 1726 Kingsley Ave, Suite 12, Orange Park, FL 32073-4463 | 2007-01-04 |
| 1972539690 | Johann Nicholas Prewett | Psychologist | 1726 Kingsley Ave, Suite 12, Orange Park, FL 32073-4463 | 2006-06-24 |
| 1023090388 | Janet Mccullough Grim | Marriage & Family Therapist | 1726 Kingsley Ave, Suite 3, Orange Park, FL 32073 | 2005-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104449008 | Ashanti Crystal Belle | Counselor | 341 Pecan Grove Dr, Orange Park, FL 32073-1945 | 2020-05-26 |
| 1992343057 | Rodney Staten | Counselor | 1050 Prairie Dunes Ct, Orange Park, FL 32065-2679 | 2019-12-19 |
| 1649817867 | Darlene Cuevas | Counselor | 2140 Kingsley Ave Ste 2, Orange Park, FL 32073-5129 | 2019-12-06 |
| 1124673249 | Family Connections Consultants | Counselor | 685 Charter Oaks Blvd, Orange Park, FL 32065-3211 | 2019-08-06 |
| 1669026324 | Evolve Therapy LLC | Counselor | 786 Blanding Blvd Ste 120, Orange Park, FL 32065-6728 | 2019-07-30 |
| 1952955965 | Tara Bryant | Counselor | 813 Maplewood Ln, Orange Park, FL 32065-6233 | 2019-07-29 |
| 1821596545 | Sheila Jean Heilman | Counselor | 2348 Glenfinnan Dr, Orange Park, FL 32073-4200 | 2018-01-28 |
| 1558890392 | J-nissi's Therapy & Counseling LLC | Counselor | 1536 Kingsley Ave Ste 120, Orange Park, FL 32073-4525 | 2017-06-06 |
| 1326597956 | Charlotte Goodson | Counselor | 2864 Moody Ave, Orange Park, FL 32073-6423 | 2016-09-23 |
| 1942673546 | Jennie Fernandez Beltz | Counselor | 2233 Park Ave Ste 301, Orange Park, FL 32073-5569 | 2015-11-04 |
| Find all providers in ORANGE PARK | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
Please comment or provide details below to improve the information on TIA 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.