Dominique M. Wilson, MA,LCPC
NPI 1225584188ActiveIndividual· Counselor, Mental Health· Carbondale, IL
Counselor, Mental Health (MA,LCPC) with Centerstone of Illinois Inc, practicing in Carbondale, Illinois. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1225584188 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MA,LCPC |
| Sole proprietor | No |
| NPI issued | Aug 31, 2016 |
| Last updated in NPPES | Mar 17, 2025 |
| Certified by provider | Mar 17, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Mental Health Primary | 101YM0800X | 180.011802 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (IL) |
|---|
Education and affiliations
| Graduation year | 2015 |
|---|---|
| Medicare specialty | Mental Health Counselor |
Medical group
- Centerstone of Illinois IncAlton, IL · 45 clinicians
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