MEDICARE: JENEE WILSON MS, LLPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	6451024909	MI
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1083405617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENEE WILSON MS, LLPC

Provider Business Mailing Address
First Line	:	4710 W SAGINAW HWY STE 1
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-2654
Country	:	US
Telephone Number	:	517-914-2288
Fax Number	:

Provider Business Practice Location Address
First Line	:	4710 W SAGINAW HWY STE 1
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-2654
Country	:	US
Telephone Number	:	517-914-2288
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2025
Last Update Date	:	03/25/2026

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