Thomas Theodore Wilson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

101271 Issued in NY

Practice address

1381 E Ridge Rd Ste 5
Rochester, NY 14621-2019

Phone

(585) 922-2500

Fax

(585) 922-2710

NPI assigned

Mar 27, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1083465264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "fax_number": "585-922-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1381 E RIDGE RD STE 5",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146212019",
            "telephone_number": "585-922-2500",
            "fax_number": "585-922-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "THOMAS",
        "middle_name": "THEODORE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-27",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "101271",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "116209",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twilson397494@direct.rochesterregional.org",
            "affiliation": "N",
            "endpointDescription": "Rochester Regional Health",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1381 E Ridge Rd Ste 5",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146212019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shalom Tahnee Wilson, LPN
• Shani A Wilson, RPA-C
• Shekeria Wilson
• Shemeka Shauntay Wilson
• Shennetta S Wilson, LPN
• Tiffany M Wilson
• Tyler John Wilson, DO
• Valerie Wilson
• Verniece Altrecia Wilson, RN, FNP
• Saadiqua M Wimes, LPN

• Clinical Social Worker in Rochester, NY
• Providers in Rochester, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.