MRS. TRACI BRENISER WILSON (NPI# 1750304291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750304291 |
| Entity Type | Individual |
| Full Name | MRS. TRACI BRENISER WILSON |
| Other Name | MS. TRACI BRENISER HAWKINS |
| Credential | MA LLP |
| Practice Address |
225 South Main St Suite B Brooklyn MI 49230 |
| Mailing Address |
124 Nicole Dr Brooklyn MI 49230 |
| Practice Telephone | 5174140065 |
| Mailing Telephone | 5174140065 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-01-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | TH008036 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | TAX ID | 204862865 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427549617 | Traci Denise Wilson | Registered Nurse | 7419 Drumlea Rd, Capitol Heights, MD 20743-3423 | 2018-05-23 |
| 1609365287 | Traci Carol Wilson | Licensed Practical Nurse | 65 Saint Francis Ave, Tiffin, OH 44883-3413 | 2018-05-09 |
| 1477914935 | Traci Wilson | Nurse Practitioner | 6040 University Town Centre Dr, Morgantown, WV 26501-2421 | 2016-03-11 |
| 1346630969 | Traci Wilson | Pharmacy Technician | 2384 Brandermill Blvd, Gambrills, MD 21054-1850 | 2015-02-03 |
| 1457751992 | Traci Wilson | Counselor | 3480 Buskirk Ave, Suite 210, Pleasant Hill, CA 94523-4341 | 2014-09-03 |
| 1073841664 | Traci L Wilson | Acupuncturist | 45 E Loucks St, Suite 014, Sheridan, WY 82801-6339 | 2009-11-19 |
| 1215129937 | Traci Wilson | Licensed Practical Nurse | 2250 Hickory Rd, Suite 240, Plymouth Meeting, PA 19462-1047 | 2007-08-16 |
| Street Address |
225 SOUTH MAIN ST SUITE B |
| City | BROOKLYN |
| State | MI |
| Zip Code | 49230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073733358 | Troy D. Burk | Chiropractor | 453 Marshall St., Brooklyn, MI 49230 | 2007-04-27 |
| 1104941061 | All Care Inc. | Home Health | 11401 M-50, Brooklyn, MI 49230 | 2007-03-20 |
| 1518056365 | Lj Gallagher Psy D and Associates Pllc | Psychologist | 451 Marshall St, Brooklyn, MI 49230 | 2006-10-12 |
| 1700806064 | Guy Young Cheng | Chiropractor | 101 Sherman St, Brooklyn, MI 49230 | 2006-07-20 |
| 1710317193 | Michelle Mcbean | Counselor | 141 N. Main St., Suite B., Brooklyn, MI 49230 | 2013-11-20 |
| 1619155058 | Leonard Joseph Gallagher II | Psychologist | 451 Marshall St, Brooklyn, MI 49230 | 2008-02-07 |
| 1821189648 | Susan Gruber | Physical Therapist | 250 S Main St, Brooklyn, MI 49230 | 2006-09-27 |
| 1871508309 | Region II Commission On Services To The Aging | Case Management | 102 N. Main St., Brooklyn, MI 49230-0189 | 2006-07-31 |
| 1437244019 | Steven Ray Hoekman | Dentist | 120 Marshall St, Box 657, Brooklyn, MI 49230-1234 | 2006-10-03 |
| 1568521458 | Dori P Tamagne | Family Medicine | Iha Brooklyn Primary Care, Suite A, Brooklyn, MI 49230-4923 | 2006-12-06 |
| Find all providers in zip 49230 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700487774 | Rebecca Kason | Psychologist | 38 Broome St Apt 2b, Brooklyn, NY 11222-5515 | 2020-11-05 |
| 1780295790 | Jiyoon Lee | Psychologist | 6 Metrotech Ctr # B020, Brooklyn, NY 11201-3840 | 2020-08-12 |
| 1912517608 | Hannah Wertz | Psychologist | 485 7th Ave Apt 3, Brooklyn, NY 11215-5545 | 2020-08-06 |
| 1023636271 | Jenny Wallier | Psychologist | 75 80th St, Brooklyn, NY 11209-3511 | 2020-07-13 |
| 1669096632 | Gaurang Choksi | Psychologist | 44 Meserole St Apt 401, Brooklyn, NY 11206-1996 | 2020-06-04 |
| 1164057436 | Clear Reflections Psychotherapy Pllc | Psychologist | 225 S Main St Ste C, Brooklyn, MI 49230-9158 | 2020-03-07 |
| 1306482021 | Sara Teta | Psychologist | 436 Court Street # 7, Brooklyn, NY 11231 | 2019-11-19 |
| 1346895125 | Margo Kahn | Psychologist | 1326 38th St, Brooklyn, NY 11218-3612 | 2019-08-07 |
| 1134773559 | Flourish Psychology, Pllc | Psychologist | 300 Cadman Plz W # 12115, Brooklyn, NY 11201-3229 | 2019-07-25 |
| 1598328007 | Scott Lyons | Psychologist | 380 Butler St Apt 3, Brooklyn, NY 11217-3103 | 2019-04-19 |
| Find all providers in BROOKLYN | ||||
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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.