MR. KEN WILSON NPI 1104223999

NPI Information

NPI: 1104223999
Provider Name: MR. KEN WILSON
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
2610 COMMONS BLVD
AUGUSTA, GA
ZIP 30909
Phone: (706) 733-1935
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MR. Ken Wilson is an addiction (substance use disorder) counselor in Augusta, GA. MR. Ken Wilson NPI is 1104223999. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2610 COMMONS BLVD
AUGUSTA, GA
ZIP 30909-080
Phone: (706) 733-1935
Fax: (706) 667-8727

The enumeration date for this NPI number is 11/24/2014 and was last updated on 11/24/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	564	GEORGIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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