Gregory Maclean Wilson, MDIV, MSS, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

SW130059 Issued in PA

Practice address

3625 Chapel Rd
Newtown Square, PA 19073-3602

Phone

(484) 427-4673

NPI assigned

Aug 10, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

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

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.

• Sage Counseling LLC

  • Clinical Social Worker
  • Newtown Square, PA
  • NPI 1144692930

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1528444858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 CHAPEL RD",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190733602",
            "telephone_number": "484-427-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 CHAPEL RD",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190733602",
            "telephone_number": "484-427-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "GREGORY",
        "middle_name": "MACLEAN",
        "credential": "MDIV, MSS, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-10",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "PA",
            "license": "SW130059",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "SW130059",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "SW130059",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW130059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• White Horse Village Therapy LLC
• Janel Wildermuth
• Lori Wilkerson
• Rachel Ellen Willner, LPCC
• Antoinette Victoria Wilson-Noble, PTA
• James Winter, M.D., PH.D.
• Wendell John Wolf, D.D.S.
• Samantha Suyon Woo, LCSW
• Stacey Woodson, MS, RD, LDN
• Laura Ann Wozniak, MS, NCC

• Social Worker in Newtown Square, PA
• Providers in Newtown Square, PA by specialty
• Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.