Individual provider Active NPI

Elizabeth Wickliffe, LCSWA

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1609759034
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P022522 Issued in NC
Practice address
3804 Park Ave Ste C
Wilmington, NC 28403-6737
Phone
(910) 240-4473
NPI assigned
Jul 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 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 P022522 NC Primary

Addresses

Primary practice location

3804 Park Ave Ste C
Wilmington, NC 28403-6737

Mailing address

3804 Park Ave Ste C
Wilmington, NC 28403-6737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P022522NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Without Walls CurrentSince Aug 3, 2025 Accepting new patients

Locations

3804 Park Ave
Ste C
Wilmington, NC 28403
Phone (910) 228-9026

Organizations & group practices 1

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": "1753920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1609759034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3804 PARK AVE STE C",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 PARK AVE STE C",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036737",
            "telephone_number": "910-240-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKLIFFE",
        "first_name": "ELIZABETH",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-31",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P022522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; 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.