Robert W Wilson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-10294 Issued in AZ

Practice address

2120 S McClintock Dr
Suite 105
Tempe, AZ 85282-2692

Phone

(480) 804-0326

Fax

(480) 804-0083

NPI assigned

Dec 28, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

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

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  AZ

  Medicare reassignment Care Compare group NPD
• Fresh Path, LLC

  • Clinical Social Worker
  • Chandler, AZ
  • NPI 1932836798
  NPD Authorized official

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

{
    "created_epoch": "1325030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492905600000",
    "number": "1093084683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E SOUTHERN AVE",
            "address_2": "STE. 735",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825691",
            "telephone_number": "480-804-0326",
            "fax_number": "480-804-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 S MCCLINTOCK DR",
            "address_2": "SUITE 105",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822692",
            "telephone_number": "480-804-0326",
            "fax_number": "480-804-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-28",
        "last_updated": "2017-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-10294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "668301",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katharine Elizabeth Wilson, FNP-C
• Katherine K. Wilson, PH.D.
• Kimberlee Van Wilson, D.O.
• Kristen Karol Wilson, PMHNP
• Maria Karla Wilson
• Sarah Wilson, RBT
• Stephen C Wilson, PMHNP
• Danny Garner Windahaven, L.I.S.A.C.
• Sandra Jean Windtberg, PT
• Gene M Winfield, D.O.

• Clinical Social Worker in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2017; 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.