Individual provider Active NPI

De Ella Dawn Wilcox, MSW, LICSW

  • Clinical Social Worker
  • Saint Cloud, MN
National Provider Identifier
1245645688
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23285 Issued in MN
Practice address
2233 Roosevelt Rd. Ste. 1
Saint Cloud, MN 56301
Phone
(320) 460-2550
Fax
(320) 217-5453
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 23285 MN Primary

Addresses

Primary practice location

2233 Roosevelt Rd. Ste. 1
Saint Cloud, MN 56301

Mailing address

PO Box 7430
Saint Cloud, MN 56302-7430
Phone (320) 460-2550

Medicare participation

Medicare enrollment files
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 13, 2019 through May 13, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
23285MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
De Ella D Wilcox LLC CurrentSince Mar 11, 2025 Accepting new patients
Center for Family Counseling Inc PastSince May 1, 2023 Accepting new patients

Locations

2233 Roosevelt Rd
Ste 1
Saint Cloud, MN 56301
Phone (320) 258-3733

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1245645688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7430",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563027430",
            "telephone_number": "320-460-2550",
            "fax_number": "320-217-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 ROOSEVELT RD. STE. 1",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "56301",
            "telephone_number": "320-460-2550",
            "fax_number": "320-217-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "DE ELLA",
        "middle_name": "DAWN",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.