Individual provider Active NPI

Stewart Alexander Wilson, LCSW

  • Clinical Social Worker
  • Norfolk, VA
National Provider Identifier
1528866860
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0906015057 Issued in VA
Practice address
5357 Henneman Dr
Norfolk, VA 23513-2401
Phone
(833) 510-4357
Fax
(866) 460-2997
NPI assigned
Mar 4, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 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 0906015057 VA Primary

Addresses

Primary practice location

5357 Henneman Dr
Norfolk, VA 23513-2401

Mailing address

4600 Montgomery Rd Ste 400
Cincinnati, OH 45212-2600
Phone (833) 510-4357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: No
  • 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
I20250403001996 VA Practitioner - Clinical Social Worker 4880118504 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0906015057VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brightview LLC CurrentSince Mar 10, 2025 Accepting new patients
Brightview LLC CurrentSince Mar 10, 2025 Accepting new patients

Locations

4600 Montgomery Rd
Ste 400
Cincinnati, OH 45212
Phone (513) 873-1269

3704 Old Forest Rd
Lynchburg, VA 24501

5357 Henneman Dr
Norfolk, VA 23513
Phone (757) 855-9700

4899 Prince William Pkwy
Woodbridge, VA 22192

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": "1741046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1528866860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MONTGOMERY RD STE 400",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122600",
            "telephone_number": "833-510-4357",
            "fax_number": "866-460-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5357 HENNEMAN DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235132401",
            "telephone_number": "833-510-4357",
            "fax_number": "866-460-2997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "STEWART",
        "middle_name": "ALEXANDER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-04",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0906015057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.