Andria Edries Wilson Thompson

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1810 Bashaw St NW
Palm Bay, FL 32907-9446

Phone

(516) 610-6884

NPI assigned

Oct 22, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1649674441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 BASHAW ST NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329079446",
            "telephone_number": "516-610-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 BASHAW ST NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329079446",
            "telephone_number": "516-610-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON THOMPSON",
        "first_name": "ANDRIA",
        "middle_name": "EDRIES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destyni Williams, OTR/L
• Maya Williams
• Monique S Williams, RBT
• Tiffanie Williams
• Wilson Speech, Langauge, and Consulting LLC
• Jeffrey Lynn Wilson, D.O.
• John Leonard Wilson Jr., PTA
• Matthew Wilson
• Shawn Wilson, PTA
• Sheryl Arlynn Wilson, ARNP

• Social Worker in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.