DR. CLARENCE CARL WILSON DBH, LPCC
NPI 1033496245
Counselor - Mental Health in Colton, CA

Q: What is Clarence Wilson's NPI number?

The NPI number for Clarence Wilson is 1033496245. It was assigned to this individual provider in the NPPES registry on November 16, 2011. The provider is also known as Dr. Carl Wilson Dbh, Lpcc, Cadc.

Q: What is Clarence Wilson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Clarence Wilson was last updated on January 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 16, 2011PECOS Enrolled

851 S MOUNT VERNON AVE STE 7A, COLTON, CA 92324(760) 241-6044(760) 820-2704 Get Directions Write a Review

NPPES record last updated: January 11, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 18, 2021, Mar 5, 2019, Feb 18, 2019 and 2 more (5 updates tracked since 2016).

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About Dr. Clarence Carl Wilson Dbh, Lpcc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CLARENCE CARL WILSON DBH, LPCC (NPI 1033496245) is an individual mental health provider in Colton, California, licensed in California (2784) and active in the NPI registry since November 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033496245

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameDR. CLARENCE CARL WILSONCredential: DBH, LPCC

Location Address851 S MOUNT VERNON AVE STE 7AColton, CA 92324-3926

Mailing Address851 S Mount Vernon Ave Ste 7aColton, CA 92324-3926 · (760) 241-6044 · Fax (760) 820-2704

Phone(760) 241-6044

Fax(760) 820-2704

Sole ProprietorYes

Enumeration DateNovember 16, 2011

Last NPPES UpdateJanuary 11, 20245 updates tracked since enumeration

NPPES CertifiedJanuary 11, 2024

✔ NPI 1033496245 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

Licenses✔ Licensed in CA · 2784✔ Licensed in IA · 074006✔ Licensed in MO · 2011031159

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License RA8320316 (CA)

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 2784 (CA)

851 S MOUNT VERNON AVE STE 7A, Colton, CA 92324

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Other Names 1

Professional Name (2)Dr. Carl Wilson Dbh, Lpcc, Cadc

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Clarence Carl Wilson Dbh, Lpcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HENRY EGBUZIEM LMFT

Marriage & Family Therapist