Active NPI
Andrea T Wilson, MSW/LSW
- Social Worker
- Vineland, NJ
National Provider Identifier
1629407523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SL05265200
- Practice address
- 1318 S Main Rd
Suite 3
Vineland, NJ 08360-6516 - Phone
- (856) 692-1600
- Fax
- (856) 692-1615
- NPI assigned
- Nov 1, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SL05265200 | NJ | Primary |
Addresses
Primary practice location
1318 S Main Rd
Suite 3
Vineland, NJ 08360-6516
Mailing address
1318 South Main Rd. #3
The Kidney Center at Vineland
Vineland, NJ 08360
Phone (856) 692-1600
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
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL05265200 | NJ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383264000000",
"number": "1629407523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1318 SOUTH MAIN RD. #3",
"address_2": "THE KIDNEY CENTER AT VINELAND",
"city": "VINELAND",
"state": "NJ",
"postal_code": "08360",
"telephone_number": "856-692-1600",
"fax_number": "856-692-1615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1318 S MAIN RD",
"address_2": "SUITE 3",
"city": "VINELAND",
"state": "NJ",
"postal_code": "083606516",
"telephone_number": "856-692-1600",
"fax_number": "856-692-1615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ANDREA",
"middle_name": "T",
"name_prefix": "Ms.",
"credential": "MSW/LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-01",
"last_updated": "2013-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL05265200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vineland, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.