Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1780828699 Individual Practitioner Female Practitioner

Shirley Jo Wilson , LPC

Counselor • Jackson, MI

Professional Overview & Biography Verified Profile Summary

Shirley Wilson, LPC is a registered healthcare professional specializing in Counselor in Jackson, MI. Practice services are available at 1200 N WEST AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1200 N West Ave

Jackson, MI 492022179

Telephone 5177891209
Associated Practice Facility / Clinic
🏢 Recovery Technology Llc Facility NPI 1144259094

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Jackson, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.8 Yrs
State Avg: 14.9 Yrs
Regional Practice Density
67 Specialists

Practicing in Jackson, MI (2610 Statewide)

Telehealth Adoption Rate
3.0% 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

CMS Verified: 2024-10-30
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Caqh
12550792 (MI)

Practice Associates & Co-Workers

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

19 Associated Practitioners
Brianne Dunn

Registered Nurse

NPI 1023975299
NPI 1043800956

Master of Arts, Licensed Professional Counselor

Chinyere Sampson , LPC, CAADC

Counselor - Professional

NPI 1104295773

Licensed Professional Counselor, CAADC

John Clark

Case Manager/Care Coordinator

NPI 1104794197
NPI 1124535489

Master of Arts, Licensed Professional Counselor, National Certified Counselor

Zakary Schaefer , RN

Registered Nurse - Psychiatric/Mental Health

NPI 1205678323

Registered Nurse

Career & Practice History Timeline

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

7 Historical Events
📍
Updated Practice Location October 30, 2024

Registered at 1200 N WEST AVE, JACKSON, MI 492022179 (Tel: 5177891209)

NPI Profile Active June 18, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location June 18, 2013

Registered at 765 MANITOU ROAD, LAKEVIEW COUNSELING CENTER, MANITOU BEACH, MI 49253 (Tel: 5174034950)

📍
Updated Business Mailing Address June 18, 2013

Registered at 5088 TOWNLEY HWY, MANITOU BEACH, MI 492539784 (Tel: 5174034950)

👤
Provider Name / Credentials Updated June 18, 2013

Recorded as SHIRLEY WILSON, LPC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 18, 2013

Counselor

🟢
Initial NPI Registration & Enumeration April 22, 2009

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: 1780828699
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 22, 2009
Last Update: October 30, 2024
Sole Proprietor: Yes

Mailing Address

5088 Townley Hwy

Manitou Beach, MI 492539784

Phone: 5174034950

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

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.