Dominique Wilson
NPI 1083369490ActiveIndividual· Counselor, Professional· Chisago City, MN
Counselor, Professional with Fairview Express Care, practicing in Chisago City, Minnesota. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1083369490 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Feb 14, 2022 |
| Last updated in NPPES | Feb 14, 2022 |
| Certified by provider | Feb 14, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Professional Primary | 101YP2500X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (MN) |
|---|
Education and affiliations
| Graduation year | 2010 |
|---|---|
| Medicare specialty | Mental Health Counselor |
| Telehealth | Offers telehealth |
Medical group
- Fairview Express CareMinneapolis, MN · 1,911 clinicians
Other Counselor, Professional providers in Chisago City
- 1982482436