Susan Wilson, LMSW, ACSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801068911 Issued in MI

Practice address

1931 Horton Rd Ste 3
Jackson, MI 49203-5599

Phone

(734) 425-0396

NPI assigned

Nov 1, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509494400000",
    "number": "1306358247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8640 HEATHER LN",
            "city": "ONSTED",
            "state": "MI",
            "postal_code": "492659744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 HORTON RD STE 3",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492035599",
            "telephone_number": "734-425-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SUSAN",
        "credential": "LMSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2017-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801068911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LARA",
            "identifier": "6801068911",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aingeal Wilson
• Alexandria June Wilson, LLMSW
• Jana Kai Wilson, PHARM. D.
• Kim Dittis Wilson, NP
• Shirley Jo Wilson, LPC
• William Wilson, LCMSW
• Dakota Wilt
• Theresa Windham, LMSW
• Jennifer Wineland, OMT
• John Wing

• Clinical Social Worker in Jackson, MI
• Providers in Jackson, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; 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.