MR. KEITH L WILSON III (NPI# 1982949988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1982949988 |
Entity Type | Individual |
Full Name | MR. KEITH L WILSON III |
Credential | MS, LPC |
Practice Address |
1330 E Cherry St # 12 Springfield MO 65802-3429 |
Practice Telephone | 4177619598 |
Mailing Telephone | 4177619598 |
Enumeration Date | 2012-12-01 |
Last Update Date | 2015-02-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YM0800X |
Counselor Specialization: Mental Health |
2012037415 | MO | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 1982949988 | 05 | |
MO | 1801285440 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467604744 | Keith C Wilson | Specialist/Technologist, Other | 2503 Robin Knoll Ct, Fresno, TX 77545-8167 | 2008-10-16 |
1609022219 | Keith Raymond Wilson | Counselor | 1596 Monroe Ave, Rochester, NY 14618-1415 | 2008-08-14 |
1346391976 | Keith Peter Wilson | Dentist | 211 N Second St, Po 727, Peotone, IL 60468-8837 | 2007-01-12 |
1578621769 | Keith Jonathan Wilson | Dentist | 10590 Enduring Freedom Dr, Us Army Dental Activity, Fort Drum, NY 13602-5005 | 2006-12-04 |
1205907615 | Keith Wilson | Chiropractor | 1717 Amwell Road, Somerset, NJ 08873 | 2006-11-10 |
1609307560 | Keith Wilson | Counselor | 8915 Sw Center St, Tigard, OR 97223-6307 | 2017-03-22 |
1851732697 | Keith Wilson | Prosthetic/Orthotic Supplier | 1823 Charlotte Ave, Nashville, TN 37203-2104 | 2013-07-09 |
1255776258 | Keith Garnett Wilson | Emergency Medicine | 155 N Fresno St, Fresno, CA 93701 | 2013-05-03 |
1720248198 | Keith D Wilson Jr. | General Practice | 11722 Reisterstown Rd, Reisterstown, MD 21136-3302 | 2008-06-10 |
1841470507 | Keith Alan Wilson | Physician Assistant | 12550 Hesperia Road, Suite100, Victorville, CA 92395-0000 | 2007-11-11 |
Street Address |
1330 E CHERRY ST # 12 |
City | SPRINGFIELD |
State | MO |
Zip Code | 65802-3429 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407454549 | Andrea Strauch | Counselor | 2024 W Chestnut Expressway Way, Springfield, MO 65802 | 2020-10-12 |
1962968867 | Chad Michael Linck | Specialist/Technologist | 2125 N Glenstone Ave, Springfield, MO 65802 | 2019-02-15 |
1790254647 | Meds To Live By | Pharmacist | 1134 N. Scarlett Way, Springfield, MO 65802 | 2018-11-21 |
1568945103 | Ficom | Non-Pharmacy Dispensing Site | 1308 North Glenstone Avenue, Springfield, MO 65802 | 2018-09-10 |
1982194775 | Karla Caballero | Marriage & Family Therapist | 8627 Montant Fort Way, 145, Sprinfield, MO 65802 | 2018-05-16 |
1780191809 | Tiffany Chawntay Coryell | Pharmacist | 1134 North Scarlett Way, Springfield, MO 65802 | 2018-01-10 |
1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
1407389596 | Medical Mile Imaging | Radiology | 3905 E Windsmore Dr, Springfield, MO 65802 | 2017-04-06 |
1346619103 | Jill A Knight | Occupational Therapist | 1601 E. Pythian, Green Valley State School, Springfield, MO 65802 | 2015-09-22 |
1447653258 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3720 E Sunshine St, Springfield, MO 65802 | 2014-10-07 |
Find all providers in zip 65802 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619576022 | Christine Cremonni | Counselor | 451 Wayne Ave, Springfield, PA 19064-2618 | 2020-10-19 |
1710585252 | Andrada Mihaila | Counselor | 120 Maple St Ste 301, Springfield, MA 01103-2216 | 2020-10-16 |
1407454549 | Andrea Strauch | Counselor | 2024 W Chestnut Expressway Way, Springfield, MO 65802 | 2020-10-12 |
1205443462 | India Iasia Kyles | Counselor | 82 Tilton St, Springfield, MA 01109-2332 | 2020-09-30 |
1437765161 | Sarissa Joy Adams | Counselor | 1915 E Nottingham St, Springfield, MO 65804-7733 | 2020-09-18 |
1568098952 | Jennifer Corsi | Counselor | 130 Maple St Ste 201, Springfield, MA 01103-2214 | 2020-03-17 |
1245865500 | Annette Lynn Brandenburg | Counselor | 1736 E Sunshine St Ste 811, Springfield, MO 65804-1334 | 2020-03-06 |
1962045443 | Emilie Noel Phillips | Counselor | 3826 E Lomita St, Springfield, MO 65809-3710 | 2019-10-28 |
1265082234 | Sierra Jane Forney | Counselor | 98 Garnet St, Springfield, MA 01129-1908 | 2019-09-12 |
1700438678 | Julie Ann Blythe | Counselor | 620 N Walnut St, Springfield, IL 62702-4930 | 2019-07-11 |
Find all providers in SPRINGFIELD |
City | SPRINGFIELD |
Zip Code | 65802 |
Please comment or provide details below to improve the information on MR. KEITH L WILSON III.
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.