Active NPI
Jodi Wilson, MSSW
- Clinical Social Worker
- Omaha, NE
National Provider Identifier
1275715617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2114
- Practice address
- 4101 Woolworth Ave
Omaha, NE 68105-1850 - Phone
- (402) 995-4304
- Fax
- (402) 977-5683
- NPI assigned
- Nov 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2114 | NE | Primary |
Addresses
Primary practice location
4101 Woolworth Ave
Omaha, NE 68105-1850
Mailing address
4101 Woolworth Ave
Omaha, NE 68105-1850
Phone (402) 995-4304
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2114 | NE | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196208000000",
"number": "1275715617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4101 WOOLWORTH AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051850",
"telephone_number": "402-995-4304",
"fax_number": "402-977-5683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 WOOLWORTH AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051850",
"telephone_number": "402-995-4304",
"fax_number": "402-977-5683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JODI",
"name_prefix": "Mr.",
"credential": "MSSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-28",
"last_updated": "2007-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NE",
"license": "2114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.