SHANE RAY WILSON LPC,LADC
NPI 1063742138
Counselor - Professional in Norman, OK
About Shane Ray Wilson Lpc,ladc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHANE RAY WILSON LPC,LADC (NPI 1063742138) is an individual professional provider in Norman, Oklahoma, licensed in Oklahoma (2179) and active in the NPI registry since January 2010. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shane Ray Wilson Lpc,ladc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Shane Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Norman, OK 73072
- Reassigned Medicare billing, Oklahoma enrollment
- 3 clinicians in this Medicare group
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 19
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NORMAN, OK 73072
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 Shane Wilson's NPI number?
The NPI number for Shane Wilson is 1063742138. It was assigned to this individual provider in the NPPES registry on January 12, 2010.
Where is Shane Wilson located?
Shane Wilson practices at 3750 W Main St Ste Aa, Norman, OK 73072. The listed phone number is (405) 474-9374.
What is Shane Wilson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Shane Wilson enrolled in Medicare?
Yes. Shane Wilson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Shane Wilson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shane Wilson reassigns Medicare benefits to Oklahoma Mental Health Consulting LLC (Norman, OK). 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 Shane 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 Shane Wilson was last updated on December 21, 2023. 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.
# Shane Ray Wilson, LPC,LADC · NPI 1063742138
Professional provider in Norman, Oklahoma. Individual provider, active in the CMS NPPES registry since January 12, 2010.
## Identity
- **NPI:** 1063742138 (Entity type: Individual)
- **Enumerated:** January 12, 2010
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 2179 (Oklahoma)
- **Sole proprietor:** No
## Practice location
- **Address:** 3750 W MAIN ST STE AA, Norman, OK 73072-4645
- **Phone:** (405) 474-9374
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Oklahoma Mental Health Consulting LLC (NPI 1821436064, Norman, OK), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 21, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1063742138) · Data from the CMS NPPES public registry.