MICHAEL LAWRENCE WILSON M.A.
NPI 1639560576
Counselor in Portland, OR

Q: What is Michael Wilson's NPI number?

The NPI number for Michael Wilson is 1639560576. It was assigned to this individual provider in the NPPES registry on February 13, 2015.

Q: What is Michael Wilson's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Michael Wilson was last updated on February 18, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since February 13, 2015

709 NW EVERETT ST, PORTLAND, OR 97209(503) 226-4060(503) 445-4913 Get Directions Write a Review

NPPES record last updated: February 18, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Michael Lawrence Wilson M.a. NPPES

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

MICHAEL LAWRENCE WILSON M.A. (NPI 1639560576) is an individual counselor in Portland, Oregon, licensed in Oregon (L6028) and active in the NPI registry since February 2015.

NPPES Registry Identity

NPI1639560576

Entity TypeIndividualMale

Primary Taxonomy101Y00000X

Provider Legal NameMICHAEL LAWRENCE WILSONCredential: M.A.

Location Address709 NW EVERETT STPortland, OR 97209-3517

Mailing Address232 Nw 6th AvePortland, OR 97209-3609 · (503) 294-1681 · Fax (503) 294-4321

Phone(503) 226-4060

Fax(503) 445-4913

Sole ProprietorNo

Enumeration DateFebruary 13, 2015

Last NPPES UpdateFebruary 18, 2015

✔ NPI 1639560576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in OR · L6028

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License L6028 (OR)

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License L6028 (OR)

709 NW EVERETT ST, Portland, OR 97209

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Other Providers at the Same Location NPPES 20

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

JOHN PAUL KELLEY QMHA

Case Manager/Care Coordinator