Hazel A. Wilson, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10096 Issued in SC

Practice address

1061 Harmon Ave
Fort Stewart, GA 31314-5674

Phone

(912) 435-6367

NPI assigned

May 26, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Hazel Arlean Wilson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Life Enrichment Services Center

  • Clinical Social Worker
  • Rowland, NC
  • NPI 1255693438
  NPD (past) Authorized official

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1700105053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145674",
            "telephone_number": "912-435-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145674",
            "telephone_number": "912-435-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "HAZEL",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-26",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006810",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "10096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405127",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAZEL",
            "last_name": "WILSON",
            "middle_name": "ARLEAN",
            "prefix": "DR.",
            "credential": "DMIN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Morgan P. Williamson, M.D.
• Sheila Williamson, RN
• Susan Holt Williamson, APRN-BC
• James Leslie Willis, NREMT-P
• Stephen Willis, LISW-CP, BCD
• Lisa A Wilson, PA-C
• Tiniki Wilson
• Velma Jean Wilson, MSW,LMSW
• James Jack Winchell
• Winn Army Community

• Clinical Social Worker in Fort Stewart, GA
• Providers in Fort Stewart, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.