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Deactivated NPI 1811173719 Deactivated / Inactive NPI Female Practitioner

Beverly K Wilson , RNC, FT, MA, LPC

Counselor - Professional • Jackson, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Beverly Wilson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 10, 2008
NPI Deactivation Date March 30, 2022
Total Practice Duration ~14 Years of Practice (2008 – 2022)

Professional Overview & Biography Verified Profile Summary

Beverly Wilson, RNC, FT, MA, LPC was a registered Counselor - Professional practicing in Jackson, MI. Throughout an active medical career spanning 14 years, Beverly Wilson provided care at the practice location at 1214 COOPER ST until profile deactivation on 2022-03-30.

Practice Location & Contact Primary Location

Practice Address

1214 Cooper St
Suite #201

Jackson, MI 492022496

Telephone 5177897227
Associated Practice Facility / Clinic
🏢 Grief Matters, L.l.c. Facility NPI 1225214992

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Jackson, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.7 Yrs
State Avg: 15.6 Yrs
Regional Practice Density
107 Specialists

Practicing in Jackson, MI (5077 Statewide)

Telehealth Adoption Rate
1.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License MI 6401009068

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Sandra Schopmeyer , LMSW

Social Worker - Clinical

NPI 1710269600

Licensed Master Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
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NPI Profile Deactivated March 30, 2022

Record deactivated on March 30, 2022

NPI Profile Active October 10, 2017

NPI status registered as active in NPPES database

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Updated Practice Location October 10, 2017

Registered at 3425 FRANCIS ST, JACKSON, MI 492035052 (Tel: 5177827551)

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Updated Business Mailing Address October 10, 2017

Registered at 3425 FRANCIS ST, JACKSON, MI 492035052 (Tel: 5177822551)

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Provider Name / Credentials Updated October 10, 2017

Recorded as BEVERLY WILSON, RN, FT, LPC

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 10, 2017

Counselor (License #6401009068 in MI)

NPI Profile Active January 10, 2008

NPI status registered as active in NPPES database

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Updated Practice Location January 10, 2008

Registered at 1214 COOPER ST, SUITE #201, JACKSON, MI 492022496 (Tel: 5177897227)

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Updated Business Mailing Address January 10, 2008

Registered at PO BOX 576, JACKSON, MI 492040576 (Tel: 5177897227)

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Provider Name / Credentials Updated January 10, 2008

Recorded as BEVERLY WILSON, RNC, FT, MA, LPC

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 10, 2008

Counselor (License #6401009068 in MI)

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Initial NPI Registration & Enumeration January 10, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1811173719
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 10, 2008
Last Update: January 10, 2008
Deactivation Date: March 30, 2022

Mailing Address

Po Box 576

Jackson, MI 492040576

Phone: 5177897227

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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