Ali Wilburn LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW015351 Issued in PA

Legal business name

ALI WILBURN LCSW LLC

Practice address

5 Mystic LN
Malvern, PA 19355-1942

Phone

(610) 716-3979

NPI assigned

Jun 2, 2015

Last updated

Jun 2, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Alexis True Wilburn, LCSWNPI 1093865602

Title

Psychotherapist

Phone

(610) 716-3979

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alexis True Wilburn

  • Clinical Social Worker
  • Malvern, PA
  • NPI 1093865602
  Medicare reassignment NPD Authorized official
• Therese M. Cavanaugh, CSW

  • Clinical Social Worker
  • Malvern, PA
  • NPI 1063506996
  NPD (past)
• Carolyn Patrice Smith, LCSW

  • Clinical Social Worker
  • Downingtown, PA
  • NPI 1881649010
  NPD (past)

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433203200000",
    "number": "1609256973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MYSTIC LN",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551942",
            "telephone_number": "610-716-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MYSTIC LN",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551942",
            "telephone_number": "610-716-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALI WILBURN LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-06-02",
        "status": "A",
        "authorized_official_last_name": "WILBURN",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_middle_name": "TRUE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "610-716-3979",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Malvern, PA
• Providers in Malvern, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.