Vanessa Ann Wilson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2019021666 Issued in MO

Practice address

105 Pfeiffer Ave
Kirksville, MO 63501-5047

Phone

(660) 665-4612

Fax

(660) 665-4635

NPI assigned

Jun 26, 2019

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

Enrolled in MO

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

Specialty

Clinical Social Worker

Education

University of Missouri, Columbia School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mark Twain Association for Mental Health IncGroup PAC ID 9436376969, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mark Twain Association for Mental Health, Inc.

  • Community/Behavioral Health Agency
  • Hannibal, MO
  • NPI 1700933363
  Medicare reassignment Care Compare group NPD
• Mark Twain Association for Mental Health, Inc

  • Community/Behavioral Health Agency
  • Hannibal, MO
  • NPI 1104368703
  NPD

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1710548136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PFEIFFER AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635015047",
            "telephone_number": "660-665-4612",
            "fax_number": "660-665-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PFEIFFER AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635015047",
            "telephone_number": "660-665-4612",
            "fax_number": "660-665-4635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "VANESSA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2019021666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Ann Williams, SPEECH AND LANGUAGE
• Matthew L Williams, DMD
• Corrie J Willis, RNBC, APMHCNS
• Margaret Wilson, DO
• Morriah J Wilson, LMSW
• Abigail Rose Wilt, PT, DPT
• April Winkler, FNP-BC
• Christopher Winn, PT
• Walter Vincent Winn, MA, LPC
• Amber Wireman, DO

• Clinical Social Worker in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.