Active NPI
David Farrell Wilson, LCSW
- Clinical Social Worker
- Brooklyn, NY
National Provider Identifier
1063535342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R-027340-1
- Practice address
- 83 8TH Ave
Brooklyn, NY 11215 - Phone
- (917) 751-3113
- NPI assigned
- Apr 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R-027340-1 | NY | Primary |
Addresses
Primary practice location
83 8TH Ave
Brooklyn, NY 11215
Mailing address
83 8TH Ave
Brooklyn, NY 11215-1579
Phone (917) 751-3113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180420000522 | NY | Practitioner - Clinical Social Worker | 9032472246 | Practice locations: Brooklyn, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1980
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
83 8TH Ave
Brooklyn, NY 11215-1579
Phone (917) 751-3113
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-027340-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528848000000",
"number": "1063535342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "83 8TH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112151579",
"telephone_number": "917-751-3113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "83 8TH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11215",
"telephone_number": "917-751-3113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "DAVID",
"middle_name": "FARRELL",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-09",
"last_updated": "2018-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R-027340-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; 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.