Individual provider Active NPI

Wilbert Wilson

  • Clinical Social Worker
  • Denham Springs, LA
National Provider Identifier
1477023968
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14535 Issued in LA
Practice address
30826 Linder Rd
Denham Springs, LA 70726-8507
Phone
(225) 239-5426
NPI assigned
Nov 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 14535 LA Primary

Addresses

Primary practice location

30826 Linder Rd
Denham Springs, LA 70726-8507

Mailing address

21033 Pine Knot LN
Land O Lakes, FL 34637-7827
Phone (225) 239-7830

Other practice location 1

5253 Dijon Dr Ste E
Baton Rouge, LA 70808-4393
Phone (225) 239-7830

Other practice location 2

30826 Linder Rd
Denham Springs, LA 70726-8507
Phone (225) 665-7878

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

LicenseStateTypeSpecialty
14535LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Institute for Recovery & Empowerment Past Accepting new patients
Spectrum Rehab Services, Inc. Past Accepting new patients

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": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1477023968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21033 PINE KNOT LN",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346377827",
            "telephone_number": "225-239-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30826 LINDER RD",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707268507",
            "telephone_number": "225-239-5426"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5253 Dijon Dr Ste E",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084393",
            "country_code": "US",
            "telephone_number": "225-239-7830",
            "fax_number": "866-786-0841",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30826 Linder Rd",
            "address_purpose": "LOCATION",
            "city": "Denham Springs",
            "state": "LA",
            "postal_code": "707268507",
            "country_code": "US",
            "telephone_number": "225-665-7878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "WILBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-28",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "14535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denham Springs, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.