Kathleen Wild, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5457 C Issued in NV

Practice address

6375 W Charleston Blvd
Ste A100
Las Vegas, NV 89146-1139

Phone

(702) 253-0818

Fax

(702) 253-9625

NPI assigned

May 19, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unlv MedicineGroup PAC ID 4183991458, 177 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Unlv Medicine

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1407397235
  Medicare reassignment Care Compare group NPD
• Unlv Medicine

  • Community/Retail Pharmacy
  • Las Vegas, NV
  • NPI 1184152274
  NPD
• Unsom Multi-Spec GRP Pract S

  • Surgery Physician
  • Henderson, NV
  • NPI 1053739268
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1023061801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021973",
            "telephone_number": "206-734-5445",
            "fax_number": "702-895-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6375 W CHARLESTON BLVD",
            "address_2": "STE A100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461139",
            "telephone_number": "702-253-0818",
            "fax_number": "702-253-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "KATHLEEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "5457 C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100507624",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Simmon L Wilcox, MD
• Tyler Marsh Wilcox
• Valerie Howard Wilcox
• Zach Wilcox
• John Mullane Wild, LCSW
• Tammy M Wild
• Herbert Wilde
• Laura E. Wilde, SLP
• Monique Wildenstein
• April Wilder

• Clinical Social Worker in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.