Provider Demographics
NPI:1144510678
Name:WILSON, ARLETHER (PHD, LPC, LCDC, MAC)
Entity type:Individual
Prefix:DR
First Name:ARLETHER
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:PHD, LPC, LCDC, MAC
Other - Prefix:DR
Other - First Name:ARLETHER
Other - Middle Name:
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12920 DAIRY ASHFORD RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3178
Mailing Address - Country:US
Mailing Address - Phone:832-685-6518
Mailing Address - Fax:
Practice Address - Street 1:12920 DAIRY ASHFORD RD STE 105
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3178
Practice Address - Country:US
Practice Address - Phone:832-685-6518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-18
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78471101YM0800X
TX12089101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX78471OtherTEXAS BOARD OF EXAMINERS OF PROFESIONAL COUNSELORS
TX12989OtherTEXAS DEPARTMENT OF STATE HEALTH SERVICES