Wendy I Willis, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

34004562 Issued in IN

Practice address

229 W Spring St
New Albany, IN 47150-3641

Phone

(812) 206-3291

Fax

(812) 206-3296

NPI assigned

Jun 24, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Park View Psychiatric Services, PSC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jeffersonville, IN
  • NPI 1487872636
  NPD (past)

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477559334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471510413",
            "telephone_number": "812-206-3291",
            "fax_number": "812-206-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 W SPRING ST",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471503641",
            "telephone_number": "812-206-3291",
            "fax_number": "812-206-3296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "WENDY",
        "middle_name": "I",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "34004562",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "1650",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8200051400",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "160860U",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Michael Williams, DMD
• Julia Ellen Danzl Williams, NP
• Kristina D Williams, NP
• Nicholas Williams, RBT
• Walter Keandre Desean Williams IV, OD
• Kayla Elizabeth Willoughby, MSW, LSW
• Cameron Lebron Wilson
• Creagh Page Wilson, M.ED.
• Jamie Lynn Wilson, APRN
• Janice Marie Wilson, DMD RN

• Social Worker in New Albany, IN
• Providers in New Albany, IN by specialty
• Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.