Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Raven Wilson

Individual provider Mental Health Counselor · NPI 1740725050

Raven Wilson is a Mental Health Counselor in Plattsburgh, New York. Qualified in 2016, 10 years ago. Practices with Conifer Park Inc, a 12-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
10
Licensed in
NY
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

80 Sharron Ave
Plattsburgh, NY 12901-4700
Phone: (518) 561-1447
Fax: (518) 562-8812
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 010789 (NY)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 33417 (NY)

Record details

NPI number1740725050
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 21, 2016
Last updated in NPPESJanuary 12, 2021
Certification dateJanuary 12, 2021

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Conifer Park Inc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Colleagues at Conifer Park Inc

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 12 clinicians in the practice; 10 are shown here.

Other providers in Plattsburgh