Judy M Wilson, MSW/LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-0005121 Issued in OH

Practice address

8402 Blackjack Road Ext
Mount Vernon, OH 43050-9193

Phone

(740) 397-0442

Fax

(740) 392-1814

NPI assigned

Jul 18, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Specialty

Clinical Social Worker

Education

Ohio State University College of Medicine, 1990

Medicare assignment

May accept Medicare assignment

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.

• Behavioral Healthcare Partners of Central Ohio Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Newark, OH
  • NPI 1063479079
  NPD
• Moundbuilders Guidance Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mount Vernon, OH
  • NPI 1598723728
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043239379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8402 BLACKJACK ROAD EXT",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430509193",
            "telephone_number": "740-397-0442",
            "fax_number": "740-392-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8402 BLACKJACK ROAD EXT",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430509193",
            "telephone_number": "740-397-0442",
            "fax_number": "740-392-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JUDY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MSW/LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-0005121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Williams
• Christopher Adam Willis
• David A Wilson, CMS
• Erica Wilson
• Jeannette Michelle Wilson
• Sylvia E Wineberg, MS/LSW
• Dave William Wineland, OD
• Amber Nicole Wise, PHARMD, RPH
• Sharon Renee Wise, LPN, CDCA
• Kristen N Witham, DO

• Clinical Social Worker in Mount Vernon, OH
• Providers in Mount Vernon, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.