Individual provider Active NPI

Mary D Wisecup, MSW, LCSW

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1487051561
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C009565 Issued in NC
Practice address
720 N 3Rd St Ste 101
Wilmington, NC 28401-3474
Phone
(910) 632-2191
Fax
(919) 251-7859
NPI assigned
Dec 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C009565 NC Primary

Addresses

Primary practice location

720 N 3Rd St Ste 101
Wilmington, NC 28401-3474

Mailing address

57 Wanchese Rd S Apt 102
Wilmington, NC 28411-8510
Phone (703) 587-4457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20150918000662 NC Practitioner - Clinical Social Worker 6305153669 Practice locations: Wilmington, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

720 N 3Rd St
Suite 101
Wilmington, NC 28401-3474
Phone (919) 251-2106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jeanne Marshall PLLC Clinical CurrentSince Oct 1, 2023 Accepting new patients
Insight Wellness Services PC PastSince Mar 12, 2023 Accepting new patients

Locations

720 N 3rd St
Ste 101
Wilmington, NC 28401
Phone (860) 710-2507

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": "1417651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1487051561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 WANCHESE RD S APT 102",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284118510",
            "telephone_number": "703-587-4457",
            "fax_number": "252-594-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N 3RD ST STE 101",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284013474",
            "telephone_number": "910-632-2191",
            "fax_number": "919-251-7859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISECUP",
        "first_name": "MARY",
        "middle_name": "D",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-04",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.