Active NPI
Kathryn Ann Wilson, LCSW
- Clinical Social Worker
- Wellington, CO
National Provider Identifier
1487037487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 17095
- Practice address
- 7950 6TH St
Wellington, CO 80549-1830 - Phone
- (970) 888-4070
- Fax
- (970) 372-6412
- NPI assigned
- Jul 8, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW09926974 | CO | |
| Clinical Social Worker | 1041C0700X | 17095 | TX | Primary |
Addresses
Primary practice location
7950 6TH St
Wellington, CO 80549-1830
Mailing address
7304 Cross Keys Dr
North Richland Hills, TX 76182-6057
Phone (817) 437-7574
Other practice location 1
2311 Nicholson St
Berthoud, CO 80513-7063
Phone (817) 437-7574
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW09926974 | CO | MD | Clinical Social Worker |
| 17095 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Interoperability endpoints
- kathrynwilson@tdh.allscriptsdirect.net
Organizations & group practices 1
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": "1436313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630368000000",
"number": "1487037487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7304 CROSS KEYS DR",
"city": "NORTH RICHLAND HILLS",
"state": "TX",
"postal_code": "761826057",
"telephone_number": "817-437-7574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7950 6TH ST",
"city": "WELLINGTON",
"state": "CO",
"postal_code": "805491830",
"telephone_number": "970-888-4070",
"fax_number": "970-372-6412"
}
],
"practiceLocations": [
{
"address_1": "2311 Nicholson St",
"address_purpose": "LOCATION",
"city": "Berthoud",
"state": "CO",
"postal_code": "805137063",
"country_code": "US",
"telephone_number": "817-437-7574",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "KATHRYN",
"middle_name": "ANN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-08",
"last_updated": "2021-08-31",
"certification_date": "2021-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "CSW09926974",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "17095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wellington, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.