Loni Amanda Wilson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.018037 Issued in IL

Practice address

321 W State St
Suite 5
Rockford, IL 61101-1137

Phone

(815) 969-8836

Fax

(815) 969-8871

NPI assigned

Apr 3, 2016

Last updated

Apr 3, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1459641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459641600000",
    "number": "1245693506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 W STATE ST",
            "address_2": "SUITE 5",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611011137",
            "telephone_number": "815-969-8836",
            "fax_number": "815-969-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W STATE ST",
            "address_2": "SUITE 5",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611011137",
            "telephone_number": "815-969-8836",
            "fax_number": "815-969-8871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LONI",
        "middle_name": "AMANDA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-03",
        "last_updated": "2016-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willows Health Center
• Wilson Psychological Services Inc
• Jacob R Wilson, BA
• Jasmyn Wilson, RBT
• Jennifer Mary Wilson, PSYD
• Rickie Wilson, CRNA
• Shanika L Wilson, CNA
• Bethany Wiltshire, PT, MS
• Alexandra Wimberly
• Elaine M Winebrenner, PT

• Clinical Social Worker in Rockford, IL
• Providers in Rockford, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2016; 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.