Elizabeth E Wilson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3722 Issued in TN

Practice address

2917 N Highland Ave
Jackson, TN 38305-3407

Phone

(731) 300-1010

Fax

(731) 214-1816

NPI assigned

Jan 10, 2020

Last updated

Mar 27, 2020By the provider in NPPES

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: insurance@fyswellness.com

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.

• Thrive4Wholeness LLC

  • Clinical Social Worker
  • Jackson, TN
  • NPI 1346927050
  Medicare reassignment NPD Authorized official
• Thrive West Tennessee

  • Clinical Social Worker
  • Jackson, TN
  • NPI 1790472397
  NPD (past)

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1437799012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10233",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383080103",
            "telephone_number": "731-300-1007",
            "fax_number": "731-214-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2917 N HIGHLAND AVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053407",
            "telephone_number": "731-300-1010",
            "fax_number": "731-214-1816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ELIZABETH",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "3722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "feedyoursoulwellness.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2917 N Highland Ave",
            "city": "Jackson",
            "state": "TN",
            "country_code": "US",
            "postal_code": "383053407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "insurance@fyswellness.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2917 N Highland Ave",
            "city": "Jackson",
            "state": "TN",
            "country_code": "US",
            "postal_code": "383053407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anthony M Wilson, PE
• Arlene G Wilson, CRNA
• Dana Wilson, RN
• Donald A Wilson
• Dylan Wilson, PHARMD
• James M. Wilson, D.D.S.
• John Wilson
• Jonathan Wilson, MAED, ATC, LAT, CSCS
• Kristen L Wilson, LPC-MHSP (TEMP), NCC
• Laura Wilson, PT, DPT

• Clinical Social Worker in Jackson, TN
• Providers in Jackson, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.