Nicole R Wilson, MSW, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

2024024817 Issued in MO

Practice address

630 W Kearney St
Springfield, MO 65803-2508

Phone

(417) 761-5000

NPI assigned

Jul 18, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole R Bass Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1083452577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844715",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641844715",
            "telephone_number": "417-761-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W KEARNEY ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658032508",
            "telephone_number": "417-761-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "NICOLE",
        "middle_name": "R",
        "credential": "MSW, LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-18",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2024024817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "BASS",
            "middle_name": "R",
            "credential": "MSW, LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kennedy J Wilson, OT
• Leah Wilson, LPC
• Lori J. Wilson, M.D.
• Marlana Renee Wilson
• Megan Loree Wilson, PMHNP
• Regan Wilson, PA-C
• Samuel Jerod Wilson, PA-C
• Sara Lynn Wilson, PSY.D, LP
• Sierra R Wilson, BCBA
• Victor Warren Wilson, MD

• Social Worker in Springfield, MO
• Providers in Springfield, MO by specialty
• Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.