Wendy Jeanett Willis

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

512 Morrison Cir
Summersville, WV 26651-9272

Phone

(304) 880-0176

NPI assigned

Sep 28, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1336928217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 MORRISON CIR",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266519272",
            "telephone_number": "304-880-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 MORRISON CIR",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266519272",
            "telephone_number": "304-880-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "WENDY",
        "middle_name": "JEANETT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jimmy Williams
• Quentin James Williams
• Shayla Williams
• Bradley S Willis, MD
• Crystal Leigh Willis
• Angela Wilt
• Donna Marie Winebrimmer
• Kayla Marie Wingrove, MSW,LGSW
• Tamara Marshell Wiseman
• Diedre Ann Wisniewski, R.N.

• Clinical Social Worker in Summersville, WV
• Providers in Summersville, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.