| Mr David Charles Wilson, LPC | |
|
116 Dumaine Pl, Madison, MS 39110-9234 | |
| (662) 378-7888 | |
| (601) 853-2990 |
| Full Name | Mr David Charles Wilson |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 116 Dumaine Pl, Madison, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184040800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0256 (Mississippi) | Primary |
| Entity Name | Innovative Behaviorals Services, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578578092 PECOS PAC ID: 7517969850 Enrollment ID: O20070215000315 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr David Charles Wilson, LPC 116 Dumaine Pl, Madison, MS 39110-9234 Ph: (662) 378-7888 | Mr David Charles Wilson, LPC 116 Dumaine Pl, Madison, MS 39110-9234 Ph: (662) 378-7888 |
Kendyl Hensley, BA, MDIV Counselor Medicare: Not Enrolled in Medicare Practice Location: 940 Ebenezer Blvd, Madison, MS 39110 Phone: 601-790-0583 | |
Mrs. Clara Newton, MS, PLPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 505 Cobblestone Ct Ste A, Madison, MS 39110 Phone: 601-540-7422 | |
Porschia Mcdonald Cole, Counselor Medicare: Not Enrolled in Medicare Practice Location: 102 Inwood Pl, Madison, MS 39110 Phone: 769-666-1958 | |
Breda Faye Hall, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1531 Highland Colony Pkwy, Madison, MS 39110 Phone: 601-506-1459 | |
Dr. Gregory Obert, PH.D., LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7570 Old Canton Rd Ste 102, Madison, MS 39110 Phone: 601-809-5324 | |
Katherine Johnson, PLPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 208 Key Dr Ste C, Madison, MS 39110 Phone: 601-760-2050 | |
Mrs. Pamela Graef Luckett, Counselor Medicare: Medicare Enrolled Practice Location: 109 Cedar Pine Ln, Madison, MS 39110 Phone: 601-214-8160 Fax: 601-856-6356 |