Individual provider Active NPI

Daniel James Wilson, MSW, LCSW

  • Clinical Social Worker
  • Camden, NJ
National Provider Identifier
1073897575
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05622700 Issued in NJ
Practice address
400 Market St
Camden, NJ 08102-1526
Phone
(856) 361-2700
Fax
(856) 541-4139
NPI assigned
Oct 3, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05622700 NJ Primary

Addresses

Primary practice location

400 Market St
Camden, NJ 08102-1526

Mailing address

410 Smith St
North Wales, PA 19454-3033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150918001099 NJ Practitioner - Clinical Social Worker 7214244599 Reassigns benefits to 1 organization
I20260608000737 PA Practitioner - Clinical Social Worker 7214244599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Jersey Behavioral Health Resources IncorporatedGroup PAC ID 2264503937, 10 clinicians

Practice addresses (Care Compare)

400 Market St
Camden, NJ 08102-1526
Phone (856) 361-1123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05622700NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
South Jersey Behavioral Health Resources Incorporated CurrentSince Aug 3, 2015 Accepting new patients

Locations

400 Market St
Camden, NJ 08102
Phone (856) 361-1123

53 Haddonfield Rd
Ste 316
Cherry Hill, NJ 08002
Phone (856) 315-1150

2500 McClellan Ave
Ste 300
Pennsauken, NJ 08109
Phone (856) 361-1100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1073897575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 SMITH ST",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194543033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MARKET ST",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081021526",
            "telephone_number": "856-361-2700",
            "fax_number": "856-541-4139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-03",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05622700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.