Tonya M Wilson, LCSW, ED.D

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C008884 Issued in NC

Practice address

12436 Shelly Pines Dr
Charlotte, NC 28262-1034

Phone

(980) 389-4311

NPI assigned

May 21, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614988800000",
    "number": "1205093671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12436 SHELLY PINES DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621034",
            "telephone_number": "980-389-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12436 SHELLY PINES DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621034",
            "telephone_number": "980-389-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TONYA",
        "middle_name": "M",
        "credential": "LCSW, ED.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2021-03-06",
        "certification_date": "2021-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8704",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Lynn Lawson Wilson, PT, DPT
• Susan Osborne Wilson, OTR/L
• Tawanna M Wilson
• Tina Andrea Wilson, LCAS-A
• Tommy Wilson, DMD
• Tyshanna Wilson
• Wanda Wilson
• William Barrett Wilson, DDS
• Xavious Wilson, MSW, LCSW
• Kaysie Cheyenne Wilt

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.