Active NPI
Wilbert Wilson
- Clinical Social Worker
- Denham Springs, LA
National Provider Identifier
1477023968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 14535
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 14535 | LA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Community/Behavioral Health Agency
- Baton Rouge, LA
- NPI 1144569344
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Denham Springs, LA
- NPI 1356493530
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.