Nickie Deann Wilson, LADC/MH
NPI 1891147245ActiveIndividual· Counselor, Addiction (Substance Use Disorder)· Claremore, OK
Counselor, Addiction (Substance Use Disorder) (LADC/MH) with Grand Lake Mental Health Center, Inc., practicing in Claremore, Oklahoma. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1891147245 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LADC/MH |
| Sole proprietor | No |
| NPI issued | Jul 11, 2016 |
| Last updated in NPPES | Mar 31, 2021 |
| Certified by provider | Mar 31, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Addiction (Substance Use Disorder) Primary | 101YA0400X | 1345 | OK |
| Case Manager/Care Coordinator | 171M00000X | — | — |
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 (OK) |
|---|
Education and affiliations
| Graduation year | 2016 |
|---|---|
| Medicare specialty | Mental Health Counselor |
| Telehealth | Offers telehealth |
Medical group
- Grand Lake Mental Health Center, Inc.Tulsa, OK · 127 clinicians
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