Andrea Wilson, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1302802-SUPV Issued in OH

Practice address

2780 Airport Dr Ste 100
Columbus, OH 43219-2289

Phone

(614) 859-1906

Fax

(614) 645-5517

NPI assigned

Feb 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

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.

• Columbus Neighborhood Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Circleville, OH
  • NPI 1578985453
  Medicare reassignment NPD
• Third Street Community Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Marion, OH
  • NPI 1861170565
  Medicare reassignment NPD
• Third Street Community Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Bucyrus, OH
  • NPI 1669158838
  Medicare reassignment NPD
• Third Street Community Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Mansfield, OH
  • NPI 1720407554
  Medicare reassignment NPD
• Third Street Community Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mansfield, OH
  • NPI 1306499314
  Medicare reassignment NPD
• Columbus Neighborhood Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Columbus, OH
  • NPI 1497817142
  NPD
• Columbus Neighborhood Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Columbus, OH
  • NPI 1710310594
  NPD
• Columbus Neighborhood Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Columbus, OH
  • NPI 1851474993
  NPD
• Columbus Neighborhood Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Columbus, OH
  • NPI 1881756526
  NPD
• Columbus Neighborhood Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbus, OH
  • NPI 1346304151
  NPD
• Columbus Neighborhood Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbus, OH
  • NPI 1669535373
  NPD

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1154461960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 AIRPORT DR STE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432192289",
            "telephone_number": "614-859-1906",
            "fax_number": "614-645-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 AIRPORT DR STE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432192289",
            "telephone_number": "614-859-1906",
            "fax_number": "614-645-5517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 S Plum St",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "OH",
            "postal_code": "43040",
            "country_code": "US",
            "telephone_number": "937-644-9192",
            "fax_number": "937-644-3426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ANDREA",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "091086",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S1100574",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1302802-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julius Elizah Wilson-Small
• Aaron Wilson
• Ahstawn Wilson
• Allison Paige Wilson, FNP-C
• Amanda Lynn Wilson, RNFA
• Andrew Wilson
• Anne Marie Wilson
• Ariana Wilson
• Autumn Brooke Wilson, LPN
• Bianca Wilson

• Clinical Social Worker in Columbus, OH
• Providers in Columbus, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.