Tanaysha Ebony Wilson, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904011360 Issued in VA

Practice address

2025 E Main St Ste 15
Richmond, VA 23223-7069

Phone

(877) 707-5220

Fax

(888) 519-4656

NPI assigned

Nov 13, 2019

Last updated

Nov 13, 2019By 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

Enrolled in VA

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Counseling Associates IncGroup PAC ID 0941288583, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Commonwealth Counseling Associates Inc

  dba LifeStance Health

  • Clinical Psychologist
  • Mechanicsville, VA
  • NPI 1851345805
  Medicare reassignment Care Compare group
• Behavior Health & Wellness Center, LLC

  • Behavior Analyst
  • Newport News, VA
  • NPI 1962736595

  Clinical

  Medicare reassignment NPD
• Calm Waters Counseling, LLC

  • Social Worker
  • Richmond, VA
  • NPI 1982234092
  Medicare reassignment NPD
• Rva Addiction Treatment Center, LLC

  • Community/Behavioral Health Agency
  • North Chesterfield, VA
  • NPI 1225634298
  NPD (past)

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1285279257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8706 PELLINGTON PL APT 7",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232944835",
            "telephone_number": "804-319-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 E MAIN ST STE 15",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232237069",
            "telephone_number": "877-707-5220",
            "fax_number": "888-519-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TANAYSHA",
        "middle_name": "EBONY",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pam Evans Wilson, OTR
• Qunique Wilson
• Richard William Wilson, LPC LMFT
• Staci Erica Wilson, RN
• Stephanie Louise Wilson, LMFT
• Teresh Hodiah Wilson, LPC
• Toccara Wilson
• Tonya Wajciechowski Wilson, M.ED, BCBA, LBA
• Whitney Cornesha Wilson, MSW
• Barbara Louise Wiltshire, NP

• Clinical Social Worker in Richmond, VA
• Providers in Richmond, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.