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

Mr. Jerry Wilson

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1962731786

Mr. Jerry Wilson is an Addiction (Substance Use Disorder) Counselor in Shiprock, New Mexico. Licensed in New Mexico. Registered with an NPI since 2009.

Licensed in
NM
In the registry since
2009

Practice location Address checks out

Hwy 491 N Pinon St Red Modular Bldg
Shiprock, NM 87420-1830
Phone: (505) 368-1050
Fax: (505) 368-1055
Show map & directions

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

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 0122591 (NM)

Record details

NPI number1962731786
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 8, 2009
Last updated in NPPESDecember 8, 2009
Mailing addressPo Box 1830, Shiprock, NM 87420-1830

Other providers in Shiprock