Constance Elaine Wildey, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LMSW 03248 Issued in TX

Practice address

2200 Market St Ste 412
Galveston, TX 77550-1532

Phone

(409) 765-6321

Fax

(409) 762-9151

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Clinical Social Worker

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Titus Harris Clinic a Professional Association

  • Psychiatry Physician
  • Galveston, TX
  • NPI 1558440305
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639289440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 MARKET ST STE 412",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775501532",
            "telephone_number": "409-765-6321",
            "fax_number": "409-762-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 MARKET ST STE 412",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775501532",
            "telephone_number": "409-765-6321",
            "fax_number": "409-762-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDEY",
        "first_name": "CONSTANCE",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "LMSW 03248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "871291Q",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lee Roy Wiederhold III, MD, PHD
• Jana L Wieser, R.D.
• Cindy L Wigg, MD
• Dana Wild, PT
• Maureen Ann Wilder, ANP
• Mary Suna Wilkerson, MD
• Michael George Wilkerson, MD
• Denise M Wilkes, M.D.
• Robert D. Wilkins, PA
• Deyna Williams

• Clinical Social Worker in Galveston, TX
• Providers in Galveston, TX by specialty
• Clinical Social Worker in Texas

• 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.