DOMINIQUE MARIE WILSON MA, LCPC, CRC
NPI 1407345192
Counselor - Professional in O Fallon, IL
NPI Status: Active since May 08, 2018
Contact Information
785 WALL ST # 200
O FALLON, IL
ZIP 62269
Phone: (618) 367-2194
NPPES record last updated: August 11, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.
Record update history: Aug 11, 2020, May 8, 2018 (2 updates tracked since 2018).
- Individual
- Female
- Years of Experience 10
- Counselor
- Professional
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
About DOMINIQUE WILSON
This page provides the complete NPI Profile along with additional information for Dominique Wilson, a provider established in O Fallon, Illinois with a medical specialization in Counselor, focusing in professional and more than 10 years of experience. The healthcare provider is registered in the NPI registry with number 1407345192 assigned on May 2018. The practitioner's primary taxonomy code is 101YP2500X with license number 180.012945 (IL). The provider is registered as an individual and her NPI record was last updated 6 years ago.
- NPI
- 1407345192
- Provider Name
- DOMINIQUE MARIE WILSON MA, LCPC, CRC
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 785 WALL ST # 200 O FALLON, IL 62269
- Location Phone
- (618) 367-2194
- Mailing Address
- 1109 HIGH VALLEY LN BELLEVILLE, IL 62221
- Mailing Phone
- (317) 900-6556
- Medical School Name
- OTHER
- Graduation Year
- 2017
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 05-08-2018
- Last Update Date
- 08-11-2020
- Code Navigator
Location Map
Secondary Locations
- 3550 W Cheyenne Ave
North Las Vegas, NV 89032
(702) 570-5421
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Professional
- Taxonomy Code
- 101YP2500X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 180.012945
- License State
- IL
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | CI0365 (NV) |
| 2 | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | CI0365 (NV) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Balance by Medica Bronze $0 Copay PCP Visits - EPO
- Balance by Medica Bronze Premier - EPO
- Balance by Medica Expanded Bronze Standard - EPO
- Balance by Medica Gold $0 Copay PCP Visits - EPO
- Balance by Medica Gold Share - EPO
- Balance by Medica Gold Standard - EPO
- Balance by Medica Silver $0 Copay PCP Visits - EPO
- Balance by Medica Silver Share - EPO
- Balance by Medica Silver Standard - EPO
- Medica with MU Health Care Bronze $0 Copay PCP Visits - EPO
- Medica with MU Health Care Bronze Premier - EPO
- Medica with MU Health Care Expanded Bronze Standard - EPO
- Medica with MU Health Care Gold $0 Copay PCP Visits - EPO
- Medica with MU Health Care Gold Share - EPO
- Medica with MU Health Care Gold Standard - EPO
- Medica with MU Health Care Silver $0 Copay PCP Visits - EPO
- Medica with MU Health Care Silver Share - EPO
- Medica with MU Health Care Silver Standard - EPO
- Select by Medica Bronze $0 Copay PCP Visits - EPO
- Select by Medica Bronze Share - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Essential (No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
- UHC Gold Advantage ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Silver Advantage ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Standard (No Referrals) - EPO
- UHC Silver Standard+ (Dental + Vision, No Referrals) - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Dominique Wilson is registered with Medicare but may not accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
Dominique Wilson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 1557845898
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20260324003617
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
Reviews for DOMINIQUE MARIE WILSON MA, LCPC, CRC
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NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1407345192, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1407345192, enumerated as an "individual" on May 08, 2018.
The provider is located at 785 WALL ST # 200 O FALLON, IL 62269 and the phone number is (618) 367-2194.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
The provider might be accepting Accepts: Medica and UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.
