Individual provider · Type 1 NPI
Dominique Marie Wilson, MA, LCPC, CRC
Professional Counselor · O Fallon, IL
NPI number
1407345192
Active
Practice location
785 Wall St # 200
O Fallon, IL 62269-1959
Mailing address
1109 High Valley Ln
Belleville, IL 62221-6846
Other practice locations
- 3550 W Cheyenne Ave, North Las Vegas, NV 89032-8212 · (702) 570-5421
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor | 101Y00000X | CI0365 (NV) |
| Mental Health Counselor | 101YM0800X | CI0365 (NV) |
| Professional Counselor Primary | 101YP2500X | 180.012945 (IL) |
Professional Counselor: Definition to come...
Another provider at this address
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- Nancy Carol Morrison, PhDProfessional Counselor O Fallon, IL NPI 1245446376
- Lori Ann McAllister, LCPCProfessional Counselor O Fallon, IL NPI 1245495100
- Amy C. Champion, LCPCProfessional Counselor O Fallon, IL NPI 1285782474
- Michael Turner, LCPCProfessional Counselor O Fallon, IL NPI 1316707185
About NPI 1407345192
Dominique Marie Wilson, MA, LCPC, CRC's National Provider Identifier is 1407345192, issued on May 8, 2018. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in O Fallon, IL. The record was last updated on Aug 11, 2020.