DR. MIA R WILSON (NPI# 1912921743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912921743 |
| Entity Type | Individual |
| Full Name | DR. MIA R WILSON |
| Credential | ED.D |
| Practice Address |
5379 Lenox Ave Jacksonville FL 32205-4737 |
| Mailing Address |
P.o. Box 8056 Jacksonville FL 32211 |
| Practice Telephone | 9048916614 |
| Practice Fax Number | 9043789922 |
| Mailing Telephone | 9048916614 |
| Mailing Fax Number | 9043789922 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2014-08-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
2435 | FL | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH8078 | FL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649883943 | Mia Wilson | Social Worker | 180 Fairfield Ave, Bridgeport, CT 06604-4252 | 2020-08-26 |
| 1306404397 | Mia Michelle Wilson | Case Manager/Care Coordinator | 6762 Lexington Ave, Los Angeles, CA 90038-1217 | 2019-06-04 |
| Street Address |
5379 LENOX AVE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32205-4737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174537369 | Larry Tyrone Richardson | Counselor | 5379 Lenox Ave, Jacksonville, FL 32205-4737 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003466830 | Brandon Neil Hillard | Registered Nurse | 1260 Mcduff Ave. South, Suite 4, Jacksonville, FL 32205 | 2019-09-13 |
| 1720436363 | Ericka Sampson | Massage Therapist | 6859 Lenox Ave., Suite 6, Jacksonville, FL 32205 | 2016-05-24 |
| 1578921631 | Northstar Counseling | Counselor | 1672 Pershing Rd, Jacksonville, FL 32205 | 2016-02-04 |
| 1649645144 | Magaly Perez-cruz | Speech-Language Pathologist | 4101-1 College Street, Jacksonville, FL 32205 | 2015-12-09 |
| 1639448723 | First Choice Adult Daycare and Home Health Ca | Specialist | 5336 Quan Drive, Jacksonville, FL 32205 | 2011-12-20 |
| 1437434222 | Christopher Styer | Pharmacist | 654 Casset Ave, Jacksonville, FL 32205 | 2011-10-12 |
| 1871827279 | April Marie Felton | Nurse Practitioner | 500 E. Adams Street, Bay Street Health Center, Jacksonville, FL 32205 | 2009-10-01 |
| 1922244821 | Danielle Marie Sergent | Physical Therapist | 5222 Lenox Ave., Jacksonville, FL 32205 | 2008-12-23 |
| 1427181775 | Lapp & Associates Behavioral Counselind Ctr | Counselor | 931 Cassat Avenue, Jacksonville, FL 32205 | 2007-03-14 |
| 1629143326 | Elias Moussa Sargi | Dentist | 2700 Riverside Avenue, Ste 10, Jacksonville, FL 32205 | 2006-11-21 |
| Find all providers in zip 32205 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720519 | Ashley Harms | Counselor | 4070 Herschel St Ste 1, Jacksonville, FL 32210-2239 | 2020-11-03 |
| 1902418684 | Molly Ann Burkhardt | Counselor | 5776 Saint Augustine Rd # 8030, Jacksonville, FL 32207-8046 | 2020-08-23 |
| 1194335638 | Aiteria Green | Counselor | 9713 Bridgeway Ave, Jacksonville, FL 32222-2913 | 2020-08-07 |
| 1053920116 | Barbara Burden | Counselor | 209 N Carole Dr, Jacksonville, NC 28546-4845 | 2020-07-24 |
| 1790393973 | Kelley Holladay | Counselor | 1782 Plantation Oaks Dr, Jacksonville, FL 32223-5010 | 2020-07-14 |
| 1629696646 | Mary Ann Caldwell | Counselor | 2496 Northwoods Dr., Jacksonville, NC 28540 | 2020-07-07 |
| 1447877709 | Quendria Johnson-kerns | Counselor | 200 Zonnie Ln, Jacksonville, NC 28540-9729 | 2020-07-02 |
| 1467077164 | Shanna Horan | Counselor | 13500 Sutton Park Dr S Ste 702, Jacksonville, FL 32224-5290 | 2020-06-09 |
| 1720602527 | Shannon E Raikes | Counselor | 13990 Bartram Park Blvd Unit 209, Jacksonville, FL 32258-5543 | 2020-06-08 |
| 1750905253 | Kathlena N Reed | Counselor | 4131 University Blvd S Fl 32216, Jacksonville, FL 32216-4326 | 2020-06-01 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32205 |
Please comment or provide details below to improve the information on DR. MIA R 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.