Mahogany Nicole Wilson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

61015 Issued in TX

Practice address

615 W Harwood Rd
Hurst, TX 76054-3106

Phone

(817) 863-7099

NPI assigned

Aug 6, 2019

Sex

Female

Sole proprietor

Yes

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

Enrolled in TX

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  TX

  Medicare reassignment Care Compare group NPD
• Alaniz Counseling and Behavioral Center, P.C.

  • Professional Counselor
  • San Antonio, TX
  • NPI 1811288731
  Medicare reassignment NPD
• Vcounselors PLLC

  • Professional Counselor
  • San Antonio, TX
  • NPI 1326784307
  NPD

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1073168118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N STATE HIGHWAY 360 APT 2113",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W HARWOOD RD",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760543106",
            "telephone_number": "817-863-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MAHOGANY",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "61015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.simplepractice.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "615 W Harwood Rd",
            "city": "Hurst",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760543106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Risk, MD, PA
• J Brianne Williams, SLP-A
• Shaquana Williams, PTA
• Anna Tenneh Wilson
• Lillian Wilson, LPC
• Richard Paul Wilson, MD
• C Diane Winbornne, LO,BOCO, CFOM
• Alicia Anne Winkler, CCC-SLP
• Gregory S Wohl, LPC
• Jackie Wojcik, OTR

• Clinical Social Worker in Hurst, TX
• Providers in Hurst, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.