Heather Wilson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

27169 Issued in MN

Practice address

407 Washington St
Monticello, MN 55362-8815

Phone

(320) 241-4804

NPI assigned

Apr 20, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Central Minnesota Mental Health Center

  • Counselor
  • Saint Cloud, MN
  • NPI 1053576546
  NPD
• Central Minnesota Mental Health Center

  • Mental Health Counselor
  • Saint Cloud, MN
  • NPI 1831177195
  NPD

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1396326427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 WASHINGTON ST",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 WASHINGTON ST",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628815",
            "telephone_number": "320-241-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "HEATHER",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "27169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• West Metro Ophthalmology, PA
• Jenny Marie White
• Jeffrey Michael Lang Wieber, O.D.
• Meshach Josiah Williams Sr.
• Thomas Lynell Williams
• Taylor Elise Wirkus
• Robert Curtis Wudel
• Amber Lynn Wurdock
• Peggy Zimmer, LSC
• Brittany Zimmerman, M.A., LADC, LPCC

• Clinical Social Worker in Monticello, MN
• Providers in Monticello, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.