Individual provider Active NPI

Jocelyn Wilson, LCSW

  • Clinical Social Worker
  • Ames, IA
National Provider Identifier
1265786974
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.015504 Issued in IL
Practice address
2603 Northridge Pkwy Ste 103
Ames, IA 50010-4046
Phone
(515) 338-2929
Fax
(515) 337-8863
NPI assigned
Nov 1, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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 149.015504 IL Primary

Addresses

Primary practice location

2603 Northridge Pkwy Ste 103
Ames, IA 50010-4046

Mailing address

2603 Northridge Pkwy Ste 103
Ames, IA 50010-4046
Phone (515) 338-2929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130906000212 IA Practitioner - Clinical Social Worker 1153564356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2603 Northridge Pkwy
Suite 103
Ames, IA 50010-4046
Phone (515) 338-2929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.015504ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kai Lani Center for Creative Transformation and Psychotherapy Clinical CurrentSince Jan 3, 2024 Accepting new patients

Locations

2603 Northridge Pkwy
Ste 103
Ames, IA 50010
Phone (515) 338-2929

Organizations & group practices 1

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": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1265786974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 NORTHRIDGE PKWY STE 103",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500104046",
            "telephone_number": "515-338-2929",
            "fax_number": "515-337-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 NORTHRIDGE PKWY STE 103",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500104046",
            "telephone_number": "515-338-2929",
            "fax_number": "515-337-8863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOCELYN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-01",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

Verify at the official NPI Registry.