Andrew Wilson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8660 Issued in LA

Practice address

6007 Financial PLZ Ste 213
Shreveport, LA 71129-2638

Phone

(318) 458-5158

Fax

(318) 220-8108

NPI assigned

Sep 11, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Andrew Wilson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Social Work Professional Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shreveport, LA
  • NPI 1134571912
  NPD

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441929600000",
    "number": "1043688716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9817 HADRIANS WAY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711184843",
            "telephone_number": "318-458-5158",
            "fax_number": "318-220-8108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6007 FINANCIAL PLZ STE 213",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711292638",
            "telephone_number": "318-458-5158",
            "fax_number": "318-220-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ANDREW",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "8660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREW",
            "last_name": "WILSON",
            "prefix": "MR.",
            "credential": "LCSW BACS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Wilson B. Baber MD LLC
• Tenecha Latoya Wilson Lyons, LMSW
• Alaina Eve Wilson, PA
• Alexis Wilson
• Andre Wilson, B.S.
• Autumn Wilson, LMSW
• Beverly Wilson
• Brian Wilson
• Chandra Wilson, MHS
• Christopher Wilson, MD

• Clinical Social Worker in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.