NPI age
1 years
Enumerated 2024-06-24
● Active
Type 1 · Individual
Mallory Antonetta Wilson, SUDA
Wilson is 1 of 31 counselor providers in Twin Falls and 1 of 266 in Idaho.
Primary specialty
Counselor
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2024-06-24
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 266 active counselor providers in Idaho.
NPI age
1 years
↓ 8 yr below median (9 yr)
State licenses
1 state
1% of peers hold multiple states
Subspecialties
0
17% of peers hold subspecialties
NPI lifetime · 2024 → 2026
2024-06Enumerated in NPPES
2024
2026
Where they practice
Practice location
630 Addison Ave W Ste 1000
Twin Falls, ID 833015853
Mailing address
630 Addison Ave W Ste 1000
Twin Falls, ID 833015853
Specialties
-
Counselor PrimaryDefinition to come...
Practice context
Part of a multi-provider practice. 15 other active providers share this practice address in NPPES.
Recently enumerated nearby: 1 new counselor provider has been added in Twin Falls in the last 180 days.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.