Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shatisha Matrice Wilson, MS, LPC, RPT-S, ACS

Individual provider Professional Counselor · NPI 1073953253

Shatisha Matrice Wilson, MS, LPC, RPT-S, ACS is a Professional Counselor in Martinez, Georgia. Licensed in Georgia and South Carolina. Registered with an NPI since 2013.

Licensed in
GA, SC
In the registry since
2013
Specialties on file
2
What do these letters mean?
MS — Master of Science
A graduate science degree.
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

4210 Columbia Rd Ste 13B
Martinez, GA 30907-0445
Phone: (706) 496-2856
Fax: (762) 333-2872
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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 LPC008626 (GA)
Professional Counselor Taxonomy 101YP2500X · Licence PC8041 (SC)

Record details

NPI number1073953253
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , LPC , RPT-S , ACS
Sole proprietorNo
NPI enumeratedJuly 2, 2013
Last updated in NPPESJuly 3, 2024
Certification dateJuly 3, 2024

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