Jacquelyn Wilson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

31047 Issued in MD

Practice address

2300 York Rd Ste 216
Timonium, MD 21093-2276

Phone

(443) 202-7736

NPI assigned

Jan 15, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Umeed Center for Healing Relationships, LLC

  • Mental Health Counselor
  • Timonium, MD
  • NPI 1780383851

  Clinical

  NPD

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1326819590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 LUBERTHA RD",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 YORK RD STE 216",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210932276",
            "telephone_number": "443-202-7736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JACQUELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "M9984",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "31047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Williams
• Kiandra Williams
• Nakia Keishanee Williams, CRNP
• Ryan Williams, LCPC
• Silvia Oviedo Williams, M.D.
• Jewel C Wilson, LCPC
• Lakesha Wilson, CPR, ASPT, CPR ,BLS
• Monique Celeste Wilson, LCSW-C
• Tori Wilson, LCPC
• Roxanna Winkes-Anthony, LCSW-C

• Clinical Social Worker in Timonium, MD
• Providers in Timonium, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; 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.