Polly Ann Wilson, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801117015 Issued in MI

Practice address

17250 Farmington Rd
Livonia, MI 48152-3151

Phone

(734) 425-4070

Fax

(734) 425-8350

NPI assigned

May 1, 2013

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

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Detroit Central City Community Mental Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1285043406
  Medicare reassignment NPD
• Henry Ford Health Eastwood Behavioral Health

  • Social Worker
  • Clinton Township, MI
  • NPI 1396787701

  Mental Health

  Medicare reassignment NPD
• Detroit Central City Community Mental Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1598502817
  NPD

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1437594652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44000 W 12 MILE RD STE 101",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772646",
            "telephone_number": "248-226-3001",
            "fax_number": "248-347-6479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17250 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523151",
            "telephone_number": "734-425-4070",
            "fax_number": "734-425-8350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44000 W 12 Mile Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483772646",
            "country_code": "US",
            "telephone_number": "248-226-3001",
            "fax_number": "248-347-6479",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Peterboro St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012722",
            "country_code": "US",
            "telephone_number": "133-831-3160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "POLLY",
        "middle_name": "ANN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801117015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Wilson
• Kennedy Wilson
• Kirbie Wilson
• Kristen Wilson, LPC, NCC
• Michaela Joy Wilson
• Rebecca Wilson
• Sonya Felice Wilson
• Michelle Winalis, PTA
• Amy Winebarger, LMSW
• Victoria Lou Winebarger, LMSW, CAAC, CAADC

• Clinical Social Worker in Livonia, MI
• Providers in Livonia, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.