Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Deitra Wilson

Individual provider Mental Health Counselor · NPI 1700697919

Deitra Wilson is a Mental Health Counselor in Beachwood, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2025

Practice location Address checks out

24100 Chargin Blvd Ste 250
Beachwood, OH 44122
Phone: (440) 343-8069
Fax: (440) 264-1990
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence C.2406416-TRNE (OH)

Record details

NPI number1700697919
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 16, 2025
Last updated in NPPESJanuary 16, 2025
Certification dateJanuary 14, 2025
Mailing address24100 Chargin Blvd, Suite 250, Beachwood, OH 44122

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