Active NPI
Marquita D. Wilson, LCSW-C
- Clinical Social Worker
- Pikesville, MD
National Provider Identifier
1093916264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 14431
- Practice address
- 7701 Seven Mile LN
Pikesville, MD 21208-4326 - Phone
- (410) 887-1207
- Fax
- (410) 887-1259
- NPI assigned
- May 29, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 14431 | MD | Primary |
| Social Worker | 104100000X | G11181 | MD |
Addresses
Primary practice location
7701 Seven Mile LN
Pikesville, MD 21208-4326
Mailing address
7924 Lansdale Rd
Baltimore, MD 21224-2121
Phone (443) 691-1929
Other practice location 1
1406B Crain Hwy S
Suite 206
Glen Burnie, MD 21061-4099
Phone (410) 768-6088 ext. 2
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G11755 | Medicaid | MD | |
| 1093916264 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G11181 | MD | MD | Social Worker |
| 14431 | MD | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550793600000",
"number": "1093916264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7924 LANSDALE RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212242121",
"telephone_number": "443-691-1929",
"fax_number": "410-887-1259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7701 SEVEN MILE LN",
"city": "PIKESVILLE",
"state": "MD",
"postal_code": "212084326",
"telephone_number": "410-887-1207",
"fax_number": "410-887-1259"
}
],
"practiceLocations": [
{
"address_1": "1406B Crain Hwy S",
"address_2": "Suite 206",
"address_purpose": "LOCATION",
"city": "Glen Burnie",
"state": "MD",
"postal_code": "210614099",
"country_code": "US",
"telephone_number": "410-768-6088 x2",
"fax_number": "410-768-6444",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "MARQUITA",
"middle_name": "D.",
"credential": "LCSW-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-29",
"last_updated": "2019-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "14431",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "G11181",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G11755",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1093916264",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pikesville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.