Carla J Wynn, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

32044 Issued in TX

Practice address

1610 Woodstead CT Ste 420
The Woodlands, TX 77380-3404

Phone

(281) 363-4220

Fax

(281) 364-9404

NPI assigned

Aug 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 8, 2017 through May 8, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Woodlands Family Institute, PC

  • Clinical Psychologist
  • The Woodlands, TX
  • NPI 1891961090
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245342641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 WOODSTEAD CT STE 420",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773803404",
            "telephone_number": "281-363-4220",
            "fax_number": "281-364-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 WOODSTEAD CT STE 420",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773803404",
            "telephone_number": "281-363-4220",
            "fax_number": "281-364-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "CARLA",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "32044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF TEXAS",
            "identifier": "0018NU",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "241041",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole A Wright, PA-C
• Alexander Kevin Wu, MD
• Stacy Wunsch, L.AC.
• Wyatt Spine Center
• Allyson Nelms Wyatt, M.D.
• Andie Wyrick
• Ximena Millan, M.D., P.a.
• Theodore Kuo-Chun Yang, MD
• Vanessa Medina Yap, PT MBA DPT
• Jeremy Yarbrough

• Clinical Social Worker in The Woodlands, TX
• Providers in The Woodlands, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.