Active NPI
Sandra Wilson, LSW
- Social Worker
- Cleveland, OH
National Provider Identifier
1164908760
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Feb 20, 2024.
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.0012391
- Practice address
- 3100 E 45TH St Ste 314
Cleveland, OH 44127-1095 - NPI assigned
- Jul 17, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.0012391 | OH | Primary |
Addresses
Primary practice location
3100 E 45TH St Ste 314
Cleveland, OH 44127-1095
Mailing address
1070 Parkside Rd
Cleveland, OH 44108-2966
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.0012391 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531785600000",
"number": "1164908760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1070 PARKSIDE RD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441082966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 E 45TH ST STE 314",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441271095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SANDRA",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-17",
"last_updated": "2018-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.0012391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.