CEDRIC WILSON
NPI 1922624154
Counselor - Mental Health in Roanoke, VA

Q: What is Cedric Wilson's NPI number?

The NPI number for Cedric Wilson is 1922624154. It was assigned to this individual provider in the NPPES registry on June 23, 2020.

Q: What is Cedric Wilson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Cedric Wilson was last updated on October 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since June 23, 2020PECOS EnrolledAccepts Medicare Assignment

3959 ELECTRIC RD STE 330, ROANOKE, VA 24018(540) 339-7674(540) 685-0994 Get Directions Write a Review

NPPES record last updated: October 5, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 5, 2023, Mar 2, 2021, Jun 23, 2020 (3 updates tracked since 2020).

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About Cedric Wilson NPPES

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

CEDRIC WILSON (NPI 1922624154) is an individual mental health provider in Roanoke, Virginia, licensed in Virginia (0701008867) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1922624154

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameCEDRIC WILSON

Location Address3959 ELECTRIC RD STE 330Roanoke, VA 24018-4563

Mailing Address2907 Oak Crest Ave SwRoanoke, VA 24015-4609 · (540) 339-7674 · Fax (540) 685-0994

Phone(540) 339-7674

Fax(540) 685-0994

Sole ProprietorYes

Medical School CMSOtherGraduated 2017

Enumeration DateJune 23, 2020

Last NPPES UpdateOctober 5, 20233 updates tracked since enumeration

NPPES CertifiedOctober 5, 2023

✔ NPI 1922624154 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in VA · 0701008867

Also ListedCounselorTaxonomy 101Y00000X · License 0701008867 (VA)

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 0701008867 (VA)

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 0701008867 (VA)

3959 ELECTRIC RD STE 330, Roanoke, VA 24018

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Other Identifiers 1

Other1013502137VA · Npi2

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Cedric Wilson 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 ID5092292565

PECOS Enrollment IDI20260127002432

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.

Other Providers at the Same Location NPPES 5

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

EMILY BOWLES

Counselor (Mental Health)