Kevin H Wilson, ACSW-CA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ASW125314 Issued in CA

Practice address

10750 W McDowell Rd Ste C305
Avondale, AZ 85392-5964

Phone

(623) 440-1633

NPI assigned

Jan 19, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Prosper Integrated Health Care

  • Health Service Clinic/Center
  • Avondale, AZ
  • NPI 1629659578
  NPD
• Home of Purpose Empowerment

  • Mental Illness Community Based Residential Treatment Facility
  • Buckeye, AZ
  • NPI 1205465788
  NPD (past)
• Home of Purpose Empowerment LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Buckeye, AZ
  • NPI 1467138149
  NPD (past)

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

{
    "created_epoch": "1579392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738972800000",
    "number": "1033749031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10750 W MCDOWELL RD STE C305",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925964",
            "telephone_number": "402-212-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10750 W MCDOWELL RD STE C305",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925964",
            "telephone_number": "623-440-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KEVIN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "ACSW-CA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-19",
        "last_updated": "2025-02-08",
        "certification_date": "2025-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW125314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@prosperaz.org",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10750 W McDowell Rd # S305",
            "city": "Avondale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853925960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Majel Williams
• Pleashette Williams
• Faith Williamson
• Linda J Willis
• Karie I Wilson, PT, DPT
• Tammy Wingfield
• Kasie Wistar
• Melonie Witt
• Thomas Wood
• Terry E Hicks Woodbeck, MD

• Clinical Social Worker in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.