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Jennifer D Coleman Wilson

Counselor

Behavioral Health & Social Service Providers

301 W I 240 Service Rd, Oklahoma City, OK 73139-7701

PECOS Enrollment

This provider is enrolled in PECOS as JENNIFER COLEMAN WILSON.

Based on the most recent information from CMS, provider Jennifer D Coleman Wilson is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1699030916
Provider Type
Individual
Full Name
Coleman Wilson, Jennifer D
Credential
LPC

Gender
Female
Sole Proprietor
No
Enumeration Date
7/12/2012
Last Updated
6/12/2025

Contact Information

Practice Location

301 W I 240 Service Rd, Oklahoma City, OK 73139-7701

(405) 424-7711

Unlisted Fax

Mailing Location

430 W Wilshire Blvd, Oklahoma City, OK 73116-7771

(405) 761-4970

(405) 521-8652

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 11272 Oklahoma
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License 11272 Oklahoma
Code 103K00000X	Description Behavior Analyst Behavioral Health & Social Service Providers	License Unlisted Issuer

Jennifer D Coleman Wilson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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