Dominique Wilson
Dominique Wilson is a Mental Health Counselor in Chisago City, Minnesota. Qualified in 2010, 16 years ago. Practices with Fairview Express Care, a 1,964-clinician group, accepts Medicare assignment and offers telehealth.
- Years since qualifying
- 16
- In the registry since
- 2022
Practice location Address checks out
11185 Lake Blvd Ste 205Chisago City, MN 55013-9814
Phone: (952) 228-3487
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Professional Counselor (primary) | Taxonomy 101YP2500X |
|---|
Record details
| NPI number | 1083369490 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | February 14, 2022 |
| Last updated in NPPES | February 14, 2022 |
| Certification date | February 14, 2022 |
| Mailing address | 17566 Xingu St Ne, Columbus, MN 55025-8869 |
Medicare enrollment
| Medicare specialty | MENTAL HEALTH COUNSELOR |
|---|---|
| Medical school | OTHER |
| Graduated | 2010 (16 years in practice) |
| Group practice | Fairview Express Care — 1964 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Telehealth | Offers telehealth services |
Other providers in Chisago City
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Dana Marie Andersen
26190 Lofton Ave, Chisago City, MN 55013-7417 · (612) 412-0453