Mark Owen Wilson, M.S.W., L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34003687A Issued in IN

Practice address

7125 E US Highway 36
Avon, IN 46123-7968

Phone

(317) 272-2190

Fax

(317) 272-2199

NPI assigned

Apr 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Mark Owen Belue Wilson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Family Counseling Clinic

  • Mental Health Counselor
  • Avon, IN
  • NPI 1922199165
  NPD (past)
• Gabra S Gachaw MD PC

  • Mental Health Counselor
  • Danville, IN
  • NPI 1023021771
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1598887366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7125 E US HIGHWAY 36",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237968",
            "telephone_number": "317-272-2190",
            "fax_number": "317-272-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 E US HIGHWAY 36",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237968",
            "telephone_number": "317-272-2190",
            "fax_number": "317-272-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARK",
        "middle_name": "OWEN",
        "name_prefix": "Mr.",
        "credential": "M.S.W., L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003687A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "BELUE WILSON",
            "middle_name": "OWEN",
            "prefix": "MR.",
            "credential": "MSW LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Michael Williams, PT
• Michael Langham Williams, M.D.
• Nicole Ann Williams
• Shantiara Williams, RBT
• Christopher M Wilson, MD
• Rae Wilson, PT
• Steven G Wilson, CRNA
• Michelle Winbush, RBT
• Grace F Winchester, NP
• Windrose Health Network Inc

• Clinical Social Worker in Avon, IN
• Providers in Avon, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.