Wilson, Mickey

Wilson, Mickey is an individual health care provider with primary practice located at 4000 Macarthur Blvd., East Tower, 6Th Floor , Newport Beach CA 92660-2543. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Wilson, Mickey can be contacted via phone (714) 743-5612.

Contact Information

Primary practice address
4000 Macarthur Blvd., East Tower, 6Th Floor Newport Beach CA 92660-2543
Phone: (714) 743-5612
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 49203 California

Profile Details

NPI number 1669557641
LBN Legal business name Wilson, Mickey
Credentials PH.D., LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2006
Last updated Aug 16th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669557641 NPPES
California Other 49203 LICENSE

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