Angela Marie Wilbon

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904005722 Issued in VA

Practice address

720 N Saint Asaph St
Alexandria, VA 22314-1912

Phone

(703) 838-4455

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Women'S Innerfitness & Wellness Center

  • Psychologist
  • Crofton, MD
  • NPI 1225424005
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679634141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12406 WINDBROOK DR",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351155",
            "telephone_number": "301-292-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N SAINT ASAPH ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223141912",
            "telephone_number": "703-838-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBON",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "5460011003002",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "188547",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP VIRGINIA INC.",
            "identifier": "299045",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Nicole Wiederholt, LPC
• Chynna Wiggins
• Pamela Wiggins, NP
• Stephanie Wiggins
• Roger Bruce Wigton, M.D.
• Lauren Marie Wilhoit, PT, DPT
• Annette Edith Wilkins
• Edward NMN Wilkinson, D.C.
• Edward Caleb Will
• Alison Wille

• All providers in Alexandria, VA
• Clinical Social Worker in Virginia

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.