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

Kimberly Joy Wilson

Individual provider Mental Health Counselor · NPI 1760003958

Kimberly Joy Wilson is a Mental Health Counselor in Vancouver, Washington. Qualified in 2022, 4 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in Oregon and Washington.

Years since qualifying
4
Licensed in
OR, WA
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

11105 NE 14th St Ste 103
Vancouver, WA 98684-4309
Phone: (503) 850-8088
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 11192 Se 52nd Ct, Portland, OR 97222-3500 — (503) 850-8088

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence R7572 (OR)
Mental Health Counselor Taxonomy 101YM0800X · Licence MC61308406 (WA)

Record details

NPI number1760003958
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 29, 2020
Last updated in NPPESDecember 26, 2023
Certification dateDecember 26, 2023

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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