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WILLIE JOHNATHAN WELLS LPC
NPI 1952772410
Counselor - Professional in Southaven, MS

Active since October 09, 2015PECOS EnrolledAccepts Medicare Assignment
6857 COBBLESTONE BLVD, SOUTHAVEN, MS 38672(662) 253-8040(662) 470-5984 Get Directions Write a Review

NPPES record last updated: June 3, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Willie Johnathan Wells Lpc NPPES

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

WILLIE JOHNATHAN WELLS LPC (NPI 1952772410) is an individual professional provider in Southaven, Mississippi, licensed in Mississippi (1976) and active in the NPI registry since October 2015. He is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1952772410
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameWILLIE JOHNATHAN WELLSCredential: LPC
Location Address6857 COBBLESTONE BLVDSouthaven, MS 38672-9312
Mailing Address58 Timber Creek DrCordova, TN 38018-4233 · (622) 253-8040 · Fax (662) 470-5984
Phone(662) 253-8040
Fax(662) 470-5984
Sole ProprietorYes
Medical School CMSOtherGraduated 2013
Enumeration DateOctober 9, 2015
Last NPPES UpdateJune 3, 2019
✔ NPI 1952772410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MS · 1976
6857 COBBLESTONE BLVD, Southaven, MS 38672
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Other Identifiers 2

Medicaid04539260MS
MedicaidQ023618TN

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

Willie Johnathan Wells Lpc 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 ID9234588617
PECOS Enrollment IDI20240129002724
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 2

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

APRIL DIANE BAILYE LCSW
Social Worker (Clinical)
6857 COBBLESTONE BLVD
SOUTHAVEN, MS 38672
Desoto County (662) 253-8040
HEALTHQUEST, PC
Psychiatry & Neurology (Psychiatry)
6857 COBBLESTONE BLVD
SOUTHAVEN, MS 38672
Desoto County (901) 566-1002

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 Willie Wells's NPI number?

The NPI number for Willie Wells is 1952772410. It was assigned to this individual provider in the NPPES registry on October 9, 2015.

Where is Willie Wells located?

Willie Wells practices at 6857 Cobblestone Blvd, Southaven, MS 38672. The listed phone number is (662) 253-8040.

What is Willie Wells's specialty?

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

Is Willie Wells enrolled in Medicare?

Yes. Willie Wells 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.

When was this NPI record last updated?

The NPPES record for Willie Wells was last updated on June 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.