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

Ishalon Shanquell Siedah Wilson, LMHC, LPC

Individual provider Mental Health Counselor · NPI 1750126470

Ishalon Shanquell Siedah Wilson, LMHC, LPC is a Mental Health Counselor in Port St Lucie, Florida. Qualified in 2017, 9 years ago. Practices with Shardae Tripp Counseling LLC, a 12-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida and Texas.

Years since qualifying
9
Licensed in
FL, TX
In the registry since
2024
Specialties on file
2
What do these letters mean?
LMHC — Licensed Mental Health Counselor
A licensed mental health counsellor; the title used in Florida, New York and Washington among others.
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

4090 SW Jaqust St
Port St Lucie, FL 34953-5626
Phone: (850) 631-0977
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 99718 (TX)
Mental Health Counselor Taxonomy 101YM0800X · Licence MH23967 (FL)

Record details

NPI number1750126470
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMHC , LPC
Sole proprietorYes
NPI enumeratedJune 25, 2024
Last updated in NPPESJanuary 20, 2026
Certification dateJanuary 20, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Shardae Tripp Counseling Llc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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