Individual provider Active NPI

Elizabeth Pelishek Wilkinson

  • Clinical Social Worker
  • Frederick, MD
National Provider Identifier
1255889952
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2108 Brigade Cir
Frederick, MD 21702-2502
Phone
(443) 671-4509
NPI assigned
Sep 12, 2016
Last updated
Jun 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 27155 MD
Clinical Social Worker 1041C0700X 17850 FL
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

2108 Brigade Cir
Frederick, MD 21702-2502

Mailing address

3446 Bancroft St
San Diego, CA 92104-4319

Other practice location 1

3446 Bancroft St
San Diego, CA 92104-4319
Phone (301) 690-0779

Other identifiers 1

IdentifierTypeStateIssuer
043097170MedicaidMA

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

State licenses

LicenseStateTypeSpecialty
17850FLMDClinical Social Worker
27155MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mala Mantis Counseling, LLC Clinical CurrentSince Jun 29, 2025 Accepting new patients
The Guidance Center Past Accepting new patients
Riverside Community Care Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1255889952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3446 BANCROFT ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921044319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 BRIGADE CIR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217022502",
            "telephone_number": "443-671-4509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3446 Bancroft St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921044319",
            "country_code": "US",
            "telephone_number": "301-690-0779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "ELIZABETH",
        "middle_name": "PELISHEK",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "27155",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "17850",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043097170",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; 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.