Individual
DOUGLAS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
1505 N COLE ST, LIMA, OH 45801-2432
(833) 510-4357
(866) 460-2997
Mailing address
4600 MONTGOMERY RD STE 400, CINCINNATI, OH 45212-2600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
184786
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.180516
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.184786
OH
171M00000X
Case Manager/Care Coordinator
180516
OH
175T00000X
Peer Specialist
APS.002194
OH
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0315095
—
OH
Enumeration date
03/11/2021
Last updated
05/04/2026
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