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AUTUMN LYNNE WILSON MA, LPCC
NPI 1053206490
Counselor - Mental Health in Mora, MN

Active since June 09, 2025PECOS Enrolled
1884 MAHOGANY ST, MORA, MN 55051(320) 339-9963 Get Directions Write a Review

NPPES record last updated: June 9, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Autumn Lynne Wilson Ma, Lpcc NPPES

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

AUTUMN LYNNE WILSON MA, LPCC (NPI 1053206490) is an individual mental health provider in Mora, Minnesota, licensed in Minnesota (5036) and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053206490
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameAUTUMN LYNNE WILSONCredential: MA, LPCC
Location Address1884 MAHOGANY STMora, MN 55051-7111
Mailing Address7145 375th Ave NwDalbo, MN 55017-8403 · (763) 567-3875
Phone(320) 339-9963
Sole ProprietorYes
Enumeration DateJune 9, 2025
NPPES CertifiedJune 9, 2025
✔ NPI 1053206490 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MN · 5036
1884 MAHOGANY ST, Mora, MN 55051
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Autumn Lynne Wilson Ma, 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 3

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

MANES FOR CHANGE LLC
Counselor (Professional)
1884 MAHOGANY ST
MORA, MN 55051
Kanabec County (320) 339-9963
WILSON RIDGE LLC
Counselor (Mental Health)
1884 MAHOGANY ST
MORA, MN 55051
Kanabec County (763) 567-3875
KATIE LORRAINE VOSS MA, LPCC
Counselor (Mental Health)
1884 MAHOGANY ST
MORA, MN 55051
Kanabec County (320) 364-3256

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 Autumn Wilson's NPI number?

The NPI number for Autumn Wilson is 1053206490. It was assigned to this individual provider in the NPPES registry on June 9, 2025.

Where is Autumn Wilson located?

Autumn Wilson practices at 1884 Mahogany St, Mora, MN 55051. The listed phone number is (320) 339-9963.

What is Autumn Wilson's specialty?

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

Is Autumn Wilson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Autumn Wilson was last updated on June 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.