Individual provider Active NPI

Komiya Wilks, LCSW

  • Clinical Social Worker
  • Oxford, MS
National Provider Identifier
1083066369
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C8339 Issued in MS
Practice address
152 Highway 7 S
Oxford, MS 38655-5392
Phone
(662) 234-7521
Fax
(662) 236-3071
NPI assigned
Jul 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 114719 CA
Clinical Social Worker 1041C0700X CSW006870. GA
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X C8339 MS Primary

Addresses

Primary practice location

152 Highway 7 S
Oxford, MS 38655-5392

Mailing address

423 Frederick St
Sardis, MS 38666-1940
Phone (662) 654-1613

Other practice location 1

1518 Airport Rd
Hinesville, GA 31313-9439
Phone (912) 559-5536 ext. 1007

Other practice location 2

423 Frederick St
Sardis, MS 38666-1940
Phone (662) 654-1613

Other practice location 3

415 Highway 6 W
Oxford, MS 38655-9101
Phone (662) 268-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, CA2 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
I20250606003333 GA Practitioner - Clinical Social Worker 0446663769 Reassigns benefits to 1 organization
I20250611000948 CA Practitioner - Clinical Social Worker 0446663769 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW006870.GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Central Inc. Single Specialty CurrentSince Mar 31, 2025 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Teletherapeutics Health Ca Corp Single Specialty CurrentSince Mar 30, 2025 Accepting new patients
Malinda Graham and Associates Single Specialty PastSince Jul 20, 2020 Accepting new patients

Locations

18520 Pioneer Blvd
Ste 205
Artesia, CA 90701

710 Rimpau Ave
Ste 102
Corona, CA 92879
Phone (213) 373-5523

26498 Baseline St
Ste A
Highland, CA 92346

1954 Airport Rd
Chamblee, GA 30341
Phone (888) 491-6463

Interoperability endpoints

  • Direct secure messaging: komiyawilks@tdh.allscriptsdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1083066369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 FREDERICK ST",
            "city": "SARDIS",
            "state": "MS",
            "postal_code": "386661940",
            "telephone_number": "662-654-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 HIGHWAY 7 S",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555392",
            "telephone_number": "662-234-7521",
            "fax_number": "662-236-3071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1518 Airport Rd",
            "address_purpose": "LOCATION",
            "city": "Hinesville",
            "state": "GA",
            "postal_code": "313139439",
            "country_code": "US",
            "telephone_number": "912-559-5536 x1007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "423 Frederick St",
            "address_purpose": "LOCATION",
            "city": "Sardis",
            "state": "MS",
            "postal_code": "386661940",
            "country_code": "US",
            "telephone_number": "662-654-1613",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415 Highway 6 W",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MS",
            "postal_code": "386559101",
            "country_code": "US",
            "telephone_number": "662-268-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKS",
        "first_name": "KOMIYA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "114719",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006870.",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C8339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.