1. Home
  2. Directory
  3. Oklahoma
  4. Claremore
  5. Counselor
  6. NPI Profile

NICKIE DEANN WILSON LADC/MH
NPI 1891147245
Counselor - Addiction (Substance Use Disorder) in Claremore, OK

Active since July 11, 2016PECOS EnrolledAccepts Medicare Assignment
3100 MEDICAL PKWY, CLAREMORE, OK 74017(918) 342-0770(918) 342-0087 Get Directions Write a Review

NPPES record last updated: March 31, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 31, 2021, Jul 11, 2016 (2 updates tracked since 2016).

About Nickie Deann Wilson Ladc/mh NPPES

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

NICKIE DEANN WILSON LADC/MH (NPI 1891147245) is an individual addiction (substance use disorder) provider in Claremore, Oklahoma, licensed in Oklahoma (1345) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1891147245
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameNICKIE DEANN WILSONCredential: LADC/MH
Location Address3100 MEDICAL PKWYClaremore, OK 74017-1088
Mailing Address3100 Medical PkwyClaremore, OK 74017-1088 · (918) 342-0770 · Fax (918) 342-0087
Phone(918) 342-0770
Fax(918) 342-0087
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJuly 11, 2016
Last NPPES UpdateMarch 31, 20212 updates tracked since enumeration
NPPES CertifiedMarch 31, 2021
✔ NPI 1891147245 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in OK · 1345
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
3100 MEDICAL PKWY, Claremore, OK 74017
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma.Insurance ›

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

Nickie Deann Wilson Ladc/mh 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 ID2466997218
PECOS Enrollment IDI20240716004095
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 Nickie Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grand Lake Mental Health Center Inc
Same address
Mental Health (Including Community Mental Health Center)
3100 MEDICAL PKWY
Claremore, OK 74017
  • Reassigned Medicare billing, Oklahoma enrollment
  • 333 clinicians in this Medicare group
NPI 1134539141 (918) 342-0770

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 20

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

REBECCA JEAN LATTY
Case Manager/Care Coordinator
3100 MEDICAL PKWY
CLAREMORE, OK 74017
Rogers County (918) 342-0770
APRIL DAWN WILLIAMS LPN
Licensed Practical Nurse
3100 MEDICAL PKWY
CLAREMORE, OK 74017
Rogers County (844) 458-2100
HARMONY MICHELLE REVARD MSW, LCSW
Social Worker (Clinical)
3100 MEDICAL PKWY
CLAREMORE, OK 74017
Rogers County (918) 342-0770
ANGELINE JOY MCBRIDE
Peer Specialist
3100 MEDICAL PKWY
CLAREMORE, OK 74017
Rogers County (918) 342-0770
MICHAELA RUBY LACIO MHR, LPC-C
Case Manager/Care Coordinator
3100 MEDICAL PKWY
CLAREMORE, OK 74017
Rogers County (918) 342-0770
ZAIRE ARCHULETA
Counselor (Mental Health)
3100 MEDICAL PKWY
CLAREMORE, OK 74017
Rogers County (918) 342-0770
MRS. CASSIDY PAIGE GANZEL
Case Manager/Care Coordinator
3100 MEDICAL PKWY
CLAREMORE, OK 74017
Rogers County (844) 458-2100
ALLISON HENRICHS
Case Manager/Care Coordinator
3100 MEDICAL PKWY
CLAREMORE, OK 74017
Rogers County (844) 458-2100

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 Nickie Wilson's NPI number?

The NPI number for Nickie Wilson is 1891147245. It was assigned to this individual provider in the NPPES registry on July 11, 2016.

Where is Nickie Wilson located?

Nickie Wilson practices at 3100 Medical Pkwy, Claremore, OK 74017. The listed phone number is (918) 342-0770.

What is Nickie Wilson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Nickie Wilson enrolled in Medicare?

Yes. Nickie 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 Nickie Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nickie Wilson reassigns Medicare benefits to Grand Lake Mental Health Center Inc (Claremore, 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 Nickie Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nickie Wilson accept?

Health plans from Blue Cross and Blue Shield of Oklahoma list Nickie Wilson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nickie Wilson was last updated on March 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.