Linda Rene Wilson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW9848 Issued in FL

Practice address

2 Shircliff Way Ste 800
Jacksonville, FL 32204-4758

Phone

(904) 388-2619

Fax

(904) 388-0240

NPI assigned

Mar 24, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Cancer Specialists, LLC

  • Hematology & Oncology Physician
  • Jacksonville, FL
  • NPI 1528323268
  Medicare reassignment
• Youth Crisis Center, Inc.

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1770884686
  NPD (past)

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1346549730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 A C SKINNER PKWY STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566932",
            "telephone_number": "904-363-2113",
            "fax_number": "904-363-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY STE 800",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044758",
            "telephone_number": "904-388-2619",
            "fax_number": "904-388-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LINDA",
        "middle_name": "RENE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-24",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "PP353",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kiara Lee Wilson
• Kristen Michelle Wilson
• Kristian Monet Wilson, LMHC
• Kristine Ann Wilson, BS
• Laura Ann Wilson, M.A., CCC-SLP
• Mackenzie Kyra Wilson
• Marvellicia Antoinette Wilson, RCSWI
• Meaghan Catherine Wilson, DNP, APRN
• Melanie Barriger Wilson, DNP-ARNP
• Meta Wilson

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.