Jill E Wolk, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW004828 Issued in MO

Practice address

1085 Maple St
Farmington, MO 63640-1955

Phone

(573) 747-2447

Fax

(573) 756-4557

NPI assigned

Dec 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Locations

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.

• Great Mines Health Center

  • Federally Qualified Health Center (FQHC)
  • Potosi, MO
  • NPI 1376536953
  Medicare reassignment NPD
• Great Mines Health Center

  • Federally Qualified Health Center (FQHC)
  • Farmington, MO
  • NPI 1073188462
  NPD

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588725337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 OLIVE ST",
            "address_2": "SUITE 400",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032303",
            "telephone_number": "314-206-3700",
            "fax_number": "314-206-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 MAPLE ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401955",
            "telephone_number": "573-747-2447",
            "fax_number": "573-756-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLK",
        "first_name": "JILL",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "SW004828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lynn Wisdom
• Torrie Wisdom, MSW
• Erica Leigh Wofford, BS
• Anne Wolk, NP
• Derrick A. Wolk, MPT
• Womack Counseling Services LLC
• Christina M Womack
• Sarah Womack, BSW
• Sarah Marie Womack, LMT
• Michelle Lynn Woods, LPC

• Clinical Social Worker in Farmington, MO
• Providers in Farmington, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.