Jo Evelyn Wilder, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1712 Issued in KY

Practice address

9599 Summer Hill Rd
California, KY 41007-9055

Phone

(859) 635-0500

Fax

(859) 635-0504

NPI assigned

Nov 4, 2013

Last updated

Nov 4, 2013By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Holly Hill Children's Home, Inc.

  dba Holly Hill Child and Family Solutions

  • Community/Behavioral Health Agency
  • Highland Heights, KY
  • NPI 1407150402
  NPD (past)

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1699104257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4380 BATON ROUGE RD",
            "city": "WILLIAMSTOWN",
            "state": "KY",
            "postal_code": "410973067",
            "telephone_number": "859-635-0500",
            "fax_number": "859-635-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9599 SUMMER HILL RD",
            "city": "CALIFORNIA",
            "state": "KY",
            "postal_code": "410079055",
            "telephone_number": "859-635-0500",
            "fax_number": "859-635-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "JO",
        "middle_name": "EVELYN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "1712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Jan Jones, PHARMD
• Randall L Lange, RPH
• Anglia Dawn Memory, RN
• Sound Beginnings, LLC
• SRPB Inc (Flagg Springs Pharmacy)

• Clinical Social Worker in California, KY
• Providers in California, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.

Verify at the official NPI Registry.