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

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: October 25, 2026.

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

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
Open in Google Maps ↗

Other Names 1

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Clarence Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Covenant Counseling
8.4 mi
Community/Behavioral Health
6370 MAGNOLIA AVE STE 210
Riverside, CA 92506
  • Reassigned Medicare billing, California enrollment
  • 2 clinicians in this Medicare group
NPI 1164967527 (760) 241-6044

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 6

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

HENRY EGBUZIEM LMFT
Marriage & Family Therapist
851 S MOUNT VERNON AVE STE 7A
COLTON, CA 92324
San Bernardino County (760) 241-6044
MRS. SIENNA LOUISE AMBROSE LMFT
Marriage & Family Therapist
851 S MOUNT VERNON AVE STE 7A
COLTON, CA 92324
San Bernardino County (760) 241-6044
XIAOMENG DING AMFT
Counselor (Mental Health)
851 S MOUNT VERNON AVE STE 7A
COLTON, CA 92324
San Bernardino County (760) 241-6044
MAC HOPE MEDICAL AND MENTAL HEALTH CLINIC INC
Preventive Medicine (Clinical Informatics)
851 S MOUNT VERNON AVE STE 7A
COLTON, CA 92324
San Bernardino County (760) 241-6044
IRVIN OMAR JUAREZ
Counselor (Mental Health)
851 S MOUNT VERNON AVE STE 7A
COLTON, CA 92324
San Bernardino County (760) 241-6044
CARLEON CHRISTOS WILSON
Counselor (Professional)
851 S MOUNT VERNON AVE STE 7A
COLTON, CA 92324
San Bernardino County (760) 241-6044

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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.

Where is Clarence Wilson located?

Clarence Wilson practices at 851 S Mount Vernon Ave Ste 7A, Colton, CA 92324. The listed phone number is (760) 241-6044.

What is Clarence Wilson's specialty?

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

Is Clarence Wilson enrolled in Medicare?

Yes. Clarence Wilson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Clarence Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Clarence Wilson reassigns Medicare benefits to Covenant Counseling (Riverside, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Clarence Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

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.