Individual provider Active NPI

Julie Wilson, LCSW

  • Clinical Social Worker
  • West Memphis, AR
National Provider Identifier
1417076456
Registry record updated Oct 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2330-C Issued in AR
Practice address
900 N 7TH St
West Memphis, AR 72301-2001
Phone
(870) 735-3842
Fax
(870) 394-4872
NPI assigned
Mar 29, 2007
Last updated
Oct 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2017

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 2330-C AR Primary

Addresses

Primary practice location

900 N 7TH St
West Memphis, AR 72301-2001

Mailing address

900 N 7TH St
West Memphis, AR 72301-2001
Phone (870) 735-3842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20090415000227 AR Practitioner - Clinical Social Worker 5193872851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hope Counseling AssociatesGroup PAC ID 3476979220, 3 clinicians

Practice addresses (Care Compare)

215 N E Ave
Suite 201
Fayetteville, AR 72701-5296
Phone (479) 239-9181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2330-CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Counseling Associates Clinical CurrentSince Apr 28, 2020 Accepting new patients

Locations

215 N East Ave
Ste 201
Fayetteville, AR 72701
Phone (479) 239-9181

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508112000000",
    "number": "1417076456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N 7TH ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723012001",
            "telephone_number": "870-735-3842",
            "fax_number": "870-394-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N 7TH ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723012001",
            "telephone_number": "870-735-3842",
            "fax_number": "870-394-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JULIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2017-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "2330-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Memphis, AR

Sources for this page

Verify at the official NPI Registry.