Individual provider Active NPI

Felicia Lashawn Wilson, LCSW

  • Clinical Social Worker
  • Douglasville, GA
National Provider Identifier
1528720794
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW008673 Issued in GA
Practice address
9818 Forest Hill Dr
Douglasville, GA 30135-7630
Phone
(678) 386-3714
NPI assigned
Oct 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X CSW008673 GA Primary
Social Worker 104100000X MSW002777 GA

Addresses

Primary practice location

9818 Forest Hill Dr
Douglasville, GA 30135-7630

Mailing address

PO Box 6123
Douglasville, GA 30154-0019
Phone (678) 386-3714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20230922003248 GA Practitioner - Clinical Social Worker 8224498860 Practice locations: Douglasville, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Florida State University College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9818 Forest Hill Dr
Douglasville, GA 30135-7630
Phone (678) 386-3714

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MSW002777GAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1528720794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6123",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301540019",
            "telephone_number": "678-386-3714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9818 FOREST HILL DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301357630",
            "telephone_number": "678-386-3714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "FELICIA",
        "middle_name": "LASHAWN",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW008673",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW002777",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.