Angela Denise Wilson Gardner

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C008442 Issued in NC

Practice address

218 Windsor Creek Pkwy Apt a
Goldsboro, NC 27534-8695

Phone

(919) 736-8154

Fax

(919) 736-8154

NPI assigned

Aug 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1316558174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 WINDSOR CREEK PKWY APT A",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275348695",
            "telephone_number": "919-736-8154",
            "fax_number": "919-736-8154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 WINDSOR CREEK PKWY APT A",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275348695",
            "telephone_number": "919-736-8154",
            "fax_number": "919-736-8154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON GARDNER",
        "first_name": "ANGELA",
        "middle_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "C008442",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "C008442",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anastasia Nicole Willingham
• Sandy Dawn Willis, CNA1
• Paul A Willman, D.O.
• Taylor Nicole Willman
• Amy R Willoughby, CRNA
• Erika Rhavawn Wilson-Stevens
• Jamie K Wilson, COTA
• Michelle Celeste Wilson, LCSW
• Terry M Wilson, LCSW
• Daniel Shea Wines

• Clinical Social Worker in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; 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.