Active NPI
Rita Wilson
- Clinical Social Worker
- Forney, TX
National Provider Identifier
1396329975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 62261
- Practice address
- 606 Rock Brook Dr
Forney, TX 75126-4743 - Phone
- (972) 564-4335
- NPI assigned
- May 10, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 62261 | TX | Primary |
Addresses
Primary practice location
606 Rock Brook Dr
Forney, TX 75126-4743
Mailing address
PO Box 850861
Mesquite, TX 75185-0861
Other practice location 1
4500 S. Lancaster Blvd
#71A (Hud-Vash)
Dallas, TX 75216
Phone (469) 558-5887
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62261 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620604800000",
"number": "1396329975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 850861",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751850861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "606 ROCK BROOK DR",
"city": "FORNEY",
"state": "TX",
"postal_code": "751264743",
"telephone_number": "972-564-4335"
}
],
"practiceLocations": [
{
"address_1": "4500 S. Lancaster Blvd",
"address_2": "#71A (HUD-VASH)",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "75216",
"country_code": "US",
"telephone_number": "469-558-5887",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "RITA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-10",
"last_updated": "2021-05-10",
"certification_date": "2021-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "62261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forney, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.