Individual provider · Type 1 NPI

Tyra Adale Wilson

Mental Health Counselor · Philadelphia, PA

NPI number 1790636306 Active

Practice location

231 W Johnson St Apt 204
Philadelphia, PA 19144-2556

Call (215) 478-5549 Map

Fax (215) 478-5549

Other practice locations

  • 717 Bethlehem Pike Ste 310, Erdenheim, PA 19038-8120 · (267) 331-3178

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1790636306

Tyra Adale Wilson's National Provider Identifier is 1790636306, issued on Feb 9, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Philadelphia, PA. The record was last updated on Feb 9, 2026.