Jerome Wilson, - in Thibodaux, LA

Jerome Wilson, is a Counselor - Professional based in Thibodaux, Louisiana. Jerome Wilson is licensed to practice in * (Not Available) (license number ) and his current practice location is 100 Diplomat Way, Thibodaux, Louisiana. He can be reached at his office (for appointments etc.) via phone at (985) 316-6483.

NPI number for Jerome Wilson is 1922648674 and his current mailing address is 100 Diplomat Way, Thibodaux, Louisiana. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1922648674.

Contact Information

Jerome Wilson,
100 Diplomat Way,
Thibodaux, LA 70301-4314
(985) 316-6483
Not Available



Healthcare Provider's Profile

Full NameJerome Wilson
GenderMale
SpecialityCounselor - Professional
Location100 Diplomat Way, Thibodaux, Louisiana
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1922648674
  • Provider Enumeration Date: 01/10/2020
  • Last Update Date: 01/10/2020

Medical Identifiers

Medical identifiers for Jerome Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1922648674NPI-NPPES
NAMedicaidLA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TF0000XPsychologist - Family 38-3949990 (Louisiana)Secondary
103TF0000XPsychologist - Family (Louisiana)Secondary
101YP2500XCounselor - Professional (* (Not Available))Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jerome Wilson is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jerome Wilson,
100 Diplomat Way,
Thibodaux, LA 70301-4314

Ph: (985) 316-6483
Jerome Wilson,
100 Diplomat Way,
Thibodaux, LA 70301-4314

Ph: (985) 316-6483

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