Individual provider Active NPI

Jessica Ann Wilson, LCSW

  • Clinical Social Worker
  • Lafayette, IN
National Provider Identifier
1689333221
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34009419A Issued in IN
Practice address
1116 N 16TH St
Lafayette, IN 47904-2119
Phone
(765) 423-6300
Fax
(765) 423-6301
NPI assigned
Dec 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 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 34009419A IN Primary

Addresses

Primary practice location

1116 N 16TH St
Lafayette, IN 47904-2119

Mailing address

PO Box 781076
Detroit, MI 48278-1008
Phone (317) 528-4800

Other practice location 1

127 Knox Dr
West Lafayette, IN 47906-2147
Phone (765) 426-6427

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20251205002499 IN Practitioner - Clinical Social Worker 6406349521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

1116 N 16TH St
Lafayette, IN 47904-2119
Phone (765) 428-5850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34009419AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jessica Coons Counseling, LLC Clinical CurrentSince Dec 15, 2024 Accepting new patients
Franciscan Physician Network CurrentSince Nov 24, 2025 Accepting new patients
Franciscan Physician Network CurrentSince Nov 24, 2025 Accepting new patients
Winding Roads Counseling LLC Past Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1116 N 16th St
Lafayette, IN 47904
Phone (765) 423-6300

2600 Greenbush St
Lafayette, IN 47904

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Organizations & group practices 4

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": "1639094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1689333221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781008",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 N 16TH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042119",
            "telephone_number": "765-423-6300",
            "fax_number": "765-423-6301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "127 Knox Dr",
            "address_purpose": "LOCATION",
            "city": "West Lafayette",
            "state": "IN",
            "postal_code": "479062147",
            "country_code": "US",
            "telephone_number": "765-426-6427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-10",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009419A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.