1. Home
  2. Directory
  3. New Mexico
  4. Albuquerque
  5. Counselor
  6. NPI Profile

MRS. DIERDRE RYLENE WILSON MA, LPCC
NPI 1568773190
Counselor - Professional in Albuquerque, NM

Active since June 29, 2010PECOS EnrolledAccepts Medicare Assignment
4343 PAN AMERICAN FWY NE STE 221, ALBUQUERQUE, NM 87107(505) 421-0814 Get Directions Write a Review

NPPES record last updated: May 19, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 19, 2026, Nov 2, 2022, Jan 25, 2022 and 2 more (5 updates tracked since 2017).

About Mrs. Dierdre Rylene Wilson Ma, Lpcc NPPES

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

MRS. DIERDRE RYLENE WILSON MA, LPCC (NPI 1568773190) is an individual professional provider in Albuquerque, New Mexico, licensed in New Mexico (0190311) and active in the NPI registry since June 2010. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1568773190
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMRS. DIERDRE RYLENE WILSONCredential: MA, LPCC
Location Address4343 PAN AMERICAN FWY NE STE 221Albuquerque, NM 87107-6834
Mailing Address4343 Pan American Fwy Ne Ste 221Albuquerque, NM 87107-6834 · (505) 421-0814
Phone(505) 421-0814
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateJune 29, 2010
Last NPPES UpdateMay 19, 20265 updates tracked since enumeration
NPPES CertifiedMay 19, 2026
✔ NPI 1568773190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in NM · 0190311
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 0162741 (NM)
4343 PAN AMERICAN FWY NE STE 221, Albuquerque, NM 87107
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Dierdre Rylene Wilson Ma, Lpcc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5395266456
PECOS Enrollment IDI20250305001548
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 Dierdre Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Blue Fox Wellness LLC
Same address
Mental Health
4343 PAN AMERICAN FWY NE STE 221
Albuquerque, NM 87107
  • Reassigned Medicare billing, New Mexico enrollment
  • 7 clinicians in this Medicare group
NPI 1437740511 (505) 421-0814

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 7

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

MACKENZIE TYLER BIRD
Counselor (Mental Health)
4343 PAN AMERICAN FWY NE STE 221
ALBUQUERQUE, NM 87107
Bernalillo County (505) 421-0814
BLUE FOX WELLNESS LLC
Counselor (Mental Health)
4343 PAN AMERICAN FWY NE STE 221
ALBUQUERQUE, NM 87107
Bernalillo County (505) 421-0814
MAURA STEWART LMHC
Counselor (Mental Health)
4343 PAN AMERICAN FWY NE STE 221
ALBUQUERQUE, NM 87107
Bernalillo County (505) 884-1114
JESSICA HEINTZLEMAN LMHC
Counselor (Professional)
4343 PAN AMERICAN FWY NE STE 221
ALBUQUERQUE, NM 87107
Bernalillo County (505) 243-2551
MRS. STEPHANIE TURNER MA, LPCC, NCC
Counselor (Professional)
4343 PAN AMERICAN FWY NE STE 221
ALBUQUERQUE, NM 87107
Bernalillo County (505) 421-0814
ALICIA CAMERON
Counselor (Professional)
4343 PAN AMERICAN FWY NE STE 221
ALBUQUERQUE, NM 87107
Bernalillo County (505) 421-0814
TIANNA CHAVEZ
Counselor (Mental Health)
4343 PAN AMERICAN FWY NE STE 221
ALBUQUERQUE, NM 87107
Bernalillo County (505) 421-0814

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 Dierdre Wilson's NPI number?

The NPI number for Dierdre Wilson is 1568773190. It was assigned to this individual provider in the NPPES registry on June 29, 2010.

Where is Dierdre Wilson located?

Dierdre Wilson practices at 4343 Pan American Fwy NE Ste 221, Albuquerque, NM 87107. The listed phone number is (505) 421-0814.

What is Dierdre Wilson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Dierdre Wilson enrolled in Medicare?

Yes. Dierdre Wilson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Dierdre Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dierdre Wilson reassigns Medicare benefits to Blue Fox Wellness LLC (Albuquerque, NM). 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 Dierdre 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 Dierdre Wilson was last updated on May 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.