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General NPI Number Information
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NPI Number | 1295564508
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Entity Type | Individual
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Provider Name | ERICA WILSON MED, LCMHCA
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Gender | Female
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Dates
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Enumeration Date | 07/26/2024
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2611 W MAIN ST STE 6
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City | WAYNESBORO
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State | VA
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Zip | 22980-1600
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Country | US
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Telephone | 540-471-0569
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Fax |
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Provider Business Mailing Address
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Address Line | 225 WATERFRONT DR
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City | RAPHINE
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State | VA
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Zip | 24472-2544
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Country | US
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Telephone | 540-280-8005
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A20238
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License Number State | NC
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