Mini'Imah Wilson, MSW

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

15041 Cherrywood Dr
Laurel, MD 20707

Phone

(240) 583-0428

NPI assigned

Aug 31, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Az'Uels Community Connections, Inc

  • Community/Behavioral Health Agency
  • Dundalk, MD
  • NPI 1033846860
  NPD Authorized official
• Az'Ules Connections, LLC

  • Community/Behavioral Health Agency
  • Dundalk, MD
  • NPI 1265015051
  NPD Authorized official

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1376157156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15041 CHERRYWOOD DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20707",
            "telephone_number": "240-583-0428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15041 CHERRYWOOD DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20707",
            "telephone_number": "240-583-0428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MINI'IMAH",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daria Alexandra Willoughby, MSW, LCSW-C
• Wilmar Haven , Inc
• Adrian Johnston Wilson, DDS
• Diane H. Wilson
• Mary Maningue Wilson
• Tiffanie C. Winfrey, DDS
• Susanna E Winston, MD
• James Elvis Berile Wirsiy
• Crystal Marie Wissinger, BCBA
• Martha Woldemichael

• Community/Behavioral Health Agency in Laurel, MD
• Providers in Laurel, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.