Active NPI
Keanya Wilson, MSW, LICSW
- Clinical Social Worker
- Washington, DC
National Provider Identifier
1710534151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 256683
- Practice address
- 1200 1St St NE
Washington, DC 20002-3361 - Phone
- (202) 276-3911
- NPI assigned
- Aug 21, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 18846 | MD | |
| Clinical Social Worker | 1041C0700X | LC50082179 | DC | |
| School Social Worker | 1041S0200X | |||
| Clinical Social Worker | 1041C0700X | 256683 | KY | Primary |
Addresses
Primary practice location
1200 1St St NE
Washington, DC 20002-3361
Mailing address
1200 1St St NE
Washington, DC 20002-3361
Other practice location 1
500 Ala Moana Blvd
Honolulu, HI 96813-4920
Phone (415) 424-4266
Other practice location 2
16701 Melford Blvd Ste 400
Bowie, MD 20715-4411
Phone (415) 424-4266
Other practice location 3
222 E Witherspoon St
Louisville, KY 40202-6301
Phone (415) 424-4266
Other names 1
- Ms. Keanya Carr
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC50082179 | DC | MD | Clinical Social Worker |
| 256683 | KY | MD | Clinical Social Worker |
| 18846 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746662400000",
"number": "1710534151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 1ST ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200023361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 1ST ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200023361",
"telephone_number": "202-276-3911"
}
],
"practiceLocations": [
{
"address_1": "500 Ala Moana Blvd",
"address_purpose": "LOCATION",
"city": "Honolulu",
"state": "HI",
"postal_code": "968134920",
"country_code": "US",
"telephone_number": "415-424-4266",
"fax_number": "415-520-6633",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "16701 Melford Blvd Ste 400",
"address_purpose": "LOCATION",
"city": "Bowie",
"state": "MD",
"postal_code": "207154411",
"country_code": "US",
"telephone_number": "415-424-4266",
"fax_number": "415-520-6633",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "222 E Witherspoon St",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402026301",
"country_code": "US",
"telephone_number": "415-424-4266",
"fax_number": "415-520-6633",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "KEANYA",
"name_prefix": "Mrs.",
"credential": "MSW, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-21",
"last_updated": "2025-05-08",
"certification_date": "2025-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "18846",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LC50082179",
"primary": false
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "256683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KEANYA",
"last_name": "CARR",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.