Individual provider Active NPI

Steven Wilson II, LCSW

  • Clinical Social Worker
  • Marana, AZ
National Provider Identifier
1366033557
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-19151 Issued in AZ
Practice address
5224 W Dove Centre Rd
Marana, AZ 85658-5063
Phone
(520) 616-1445
Fax
(520) 616-1446
NPI assigned
Jan 29, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-19151 AZ Primary

Addresses

Primary practice location

5224 W Dove Centre Rd
Marana, AZ 85658-5063

Mailing address

PO Box 188
Marana, AZ 85653-0188
Phone (520) 616-1445

Other identifiers 1

IdentifierTypeStateIssuer
095363MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20210826003610 AZ Practitioner - Clinical Social Worker 4981009024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marana Health Center IncGroup PAC ID 2365348091, 114 clinicians

Practice addresses (Care Compare)

16701 N Oracle Rd
Suite 135
Tucson, AZ 85739-9102
Phone (520) 825-6763

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-19151AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Marana Health Center, Inc CurrentSince Jun 27, 2023 Accepting new patients
Marana Health Center Inc CurrentSince Jun 27, 2023 Accepting new patients

Locations

5224 W Dove Centre Rd
Marana, AZ 85658
Phone (520) 616-1445

2945 W Ina Rd
Ste 215
Tucson, AZ 85741

3690 S Park Ave
Ste 805
Tucson, AZ 85713
Phone (520) 616-1560

Interoperability endpoints

  • Direct secure messaging: steven.wilson.1@32652.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1366033557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-616-1445",
            "fax_number": "520-616-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5224 W DOVE CENTRE RD",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856585063",
            "telephone_number": "520-616-1445",
            "fax_number": "520-616-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STEVEN",
        "name_suffix": "II",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-29",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-19151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "095363",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marana, AZ

Sources for this page

Verify at the official NPI Registry.