REGINALD CALVERT WILSON JR. (NPI# 1720619414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720619414 |
| Entity Type | Individual |
| Full Name | REGINALD CALVERT WILSON JR. |
| Practice Address |
800 N Mangum St Ste 400 Durham NC 27701-2260 |
| Mailing Address |
520 Calloway Dr Raleigh NC 27610-4008 |
| Practice Telephone | 9196831607 |
| Mailing Telephone | 9194122662 |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2020-01-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477517563 | Reginald Wendell Wilson | Pathology | 19505 52nd Ave W, Suite A, Lynnwood, WA 98036-5409 | 2006-04-14 |
| Street Address |
800 N MANGUM ST STE 400 |
| City | DURHAM |
| State | NC |
| Zip Code | 27701-2260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104281773 | Hilda Marie Smith | Counselor | 800 N Mangum St Ste 400, Durham, NC 27701-2260 | 2015-12-23 |
| 1639784390 | Karen Collene Pandey | Counselor | 800 N Mangum St Ste 400, Durham, NC 27701-2260 | 2020-09-10 |
| 1366913345 | Monique Anchelle Conway | Counselor | 800 N Mangum St Ste 400, Durham, NC 27701-2260 | 2018-12-17 |
| 1245729474 | Megan Gibbs | Counselor | 800 N Mangum St Ste 400, Durham, NC 27701-2260 | 2018-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952956179 | Sa'naa Lenoir | Naturopath | 1213 Avondale Drive Suite 4, Durham, NC 27701 | 2019-08-05 |
| 1225682792 | Sherifat Balogun | Pharmacist | 406 Rigsbee Ave Suite 201, Durham, NC 27701 | 2019-08-01 |
| 1427575950 | Kristen Kesler Desena | Speech-Language Pathologist | 1105 Englewood Avenue, Durham, NC 27701 | 2017-08-25 |
| 1295255263 | Tiffany Claire Ashe | Social Worker | 331 W Main St Ste 308, Durham, NC 27701 | 2017-06-21 |
| 1265815096 | Colleen Hamman | Specialist/Technologist | 616 E Lawson St, Durham, NC 27701 | 2015-06-29 |
| 1366843286 | Gene Mcphaul | Counselor | 3545 Mayfair St, Durham, NC 27701 | 2014-09-10 |
| 1245652957 | Michelle Annette Underdue | Social Worker | 801 East Main Street, Suite 2-120, Durham, NC 27701 | 2014-01-15 |
| 1518306109 | Lincicome Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 300-a Northwood Circle, Durham, NC 27701 | 2013-06-18 |
| 1669754693 | Ruffin Home 2 | Assisted Living Facility | 830 N. Mangum St., Durham, NC 27701 | 2011-09-15 |
| 1609192657 | Samaritan Health Center, Inc. | Clinic/Center | 507 E. Knox Street, Durham, NC 27701 | 2010-04-15 |
| Find all providers in zip 27701 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927723 | Irene Dormenie Jackson | Counselor | 904 Woodgreen Dr, Durham, NC 27704-6034 | 2020-09-18 |
| 1285252379 | Chrissteller Taylor | Counselor | 4808 Fortunes Ridge Dr, Durham, NC 27713-9348 | 2020-07-06 |
| 1376169482 | Livia Corry | Counselor | 2410 Presidential Dr Ste 105, Durham, NC 27703-8021 | 2020-06-24 |
| 1639723794 | Philip Marschall | Counselor | 3003 Corinth Ln, Durham, NC 27704-3271 | 2019-07-27 |
| 1497317887 | Francisco Javier Contreras Hernandez | Counselor | 2020 Chapel Hill Rd, Durham, NC 27707-1184 | 2019-07-05 |
| 1235696378 | Aleesha Hughes | Counselor | 2609 N Duke St Ste 403, Durham, NC 27704-3048 | 2019-02-25 |
| 1629569280 | Nyesha Shanta Robinson | Counselor | 2530 Meridian Pkwy Ste 2055, Durham, NC 27713-5272 | 2018-05-19 |
| 1588166243 | Shane Phillips | Counselor | 411 Trent Drive, Durham, NC 27710-0001 | 2018-03-08 |
| 1366954356 | Jamie Lee Washington | Counselor | 2310 S Miami Blvd Ste 136, Durham, NC 27703-5799 | 2017-10-30 |
| 1508381369 | Lacrisha Holcomb | Counselor | 1822 East Highway 54, Suite 300, Durham, NC 27713 | 2017-08-13 |
| Find all providers in DURHAM | ||||
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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.