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DEITRA WILSON
NPI 1700697919
Counselor - Mental Health in Beachwood, OH

Active since January 16, 2025
24100 CHARGIN BLVD, SUITE 250, BEACHWOOD, OH 44122(440) 343-8069(440) 264-1990 Get Directions Write a Review

NPPES record last updated: January 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Deitra Wilson NPPES

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

DEITRA WILSON (NPI 1700697919) is an individual mental health provider in Beachwood, Ohio, licensed in Ohio (C.2406416-TRNE) and active in the NPI registry since January 2025.

NPPES Registry Identity

NPI1700697919
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameDEITRA WILSON
Location Address24100 CHARGIN BLVD, SUITE 250Beachwood, OH 44122
Mailing Address24100 Chargin Blvd, Suite 250Beachwood, OH 44122 · (440) 343-8069 · Fax (440) 264-1990
Phone(440) 343-8069
Fax(440) 264-1990
Sole ProprietorYes
Enumeration DateJanuary 16, 2025
NPPES CertifiedJanuary 14, 2025
✔ NPI 1700697919 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 OH · C.2406416-TRNE
24100 CHARGIN BLVD, Beachwood, OH 44122
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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 Deitra Wilson's NPI number?

The NPI number for Deitra Wilson is 1700697919. It was assigned to this individual provider in the NPPES registry on January 16, 2025.

Where is Deitra Wilson located?

Deitra Wilson practices at 24100 Chargin Blvd Suite 250, Beachwood, OH 44122. The listed phone number is (440) 343-8069.

What is Deitra Wilson's specialty?

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

When was this NPI record last updated?

The NPPES record for Deitra Wilson was last updated on January 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.