MEDICARE: NATOSHA NICHOLE WILSON LMFT-S, LCDC

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	106H00000X	Marriage & Family Therapist	203175	TX
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	15729	TX

General Provider Information

NPI Number	:	1730853458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATOSHA NICHOLE WILSON LMFT-S, LCDC

Provider Business Mailing Address
First Line	:	4201 FM 1960 RD W STE 235
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77068-3498
Country	:	US
Telephone Number	:	832-469-4955
Fax Number	:

Provider Business Practice Location Address
First Line	:	4201 FM 1960 RD W STE 235
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77068-3498
Country	:	US
Telephone Number	:	832-469-4955
Fax Number	:

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

Provider Enumeration Date	:	08/05/2021
Last Update Date	:	01/11/2026

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