Individual provider Active NPI

Caroline Corey Wilson, QMHP

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1467792879
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
T.2405899 Issued in OH
Practice address
2310 W Roosevelt Rd
Chicago, IL 60608-1131
Phone
(312) 477-6766
NPI assigned
Feb 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Case Manager/Care Coordinator 171M00000X CA
Clinical Social Worker 1041C0700X T.2405899 OH Primary

Addresses

Primary practice location

2310 W Roosevelt Rd
Chicago, IL 60608-1131

Mailing address

2310 W Roosevelt Rd
Chicago, IL 60608-1131
Phone (312) 477-6766

Other practice location 1

925 Brockhurst St
Oakland, CA 94608
Phone (510) 923-9600 ext. 205

Other practice location 2

905 Nebraska Ave
Toledo, OH 43607-4222
Phone (419) 841-7701

Other practice location 3

6605 W Central Ave
Toledo, OH 43617-1000
Phone (419) 841-7701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241121004344 OH Practitioner - Clinical Social Worker 1355876764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Loyola University of Chicago, Stritch School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zepf CenterGroup PAC ID 5395639215, 43 clinicians

Practice addresses (Care Compare)

6605 W Central Ave
Suite 100
Toledo, OH 43617-1000
Phone (419) 841-7701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T.2405899OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Zepf Center CurrentSince Oct 1, 2024 Accepting new patients
Zepf Center CurrentSince Oct 1, 2024 Accepting new patients

Locations

2005 Ashland Ave
Toledo, OH 43620
Phone (419) 255-3040

6605 W Central Ave
Ste 100
Toledo, OH 43617
Phone 41984177012235

905 Nebraska Ave
Toledo, OH 43607
Phone (419) 244-8848

6605 W Central Ave
Toledo, OH 43617
Phone (419) 255-4050

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1467792879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 W ROOSEVELT RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081131",
            "telephone_number": "312-477-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 W ROOSEVELT RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081131",
            "telephone_number": "312-477-6766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Brockhurst St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "94608",
            "country_code": "US",
            "telephone_number": "510-923-9600 x205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "905 Nebraska Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436074222",
            "country_code": "US",
            "telephone_number": "419-841-7701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6605 W Central Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436171000",
            "country_code": "US",
            "telephone_number": "419-841-7701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CAROLINE",
        "middle_name": "COREY",
        "credential": "QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "T.2405899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.