Heather Dawn Wilson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3819 Issued in ND

Practice address

200 Highway 2 W
Devils Lake, ND 58301-3532

Phone

(709) 166-5220

Fax

(701) 665-2300

NPI assigned

Sep 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302825600000",
    "number": "1720187016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583010650",
            "telephone_number": "701-665-2200",
            "fax_number": "701-665-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HIGHWAY 2 W",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583013532",
            "telephone_number": "709-166-5220",
            "fax_number": "701-665-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "HEATHER",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2011-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "3819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "27582",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054518",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• White Drug Co of Jamestown Inc (White Drug #47 Dba Bell Drug)
• Jennifer L. White, M.S., CCC-SLP
• Danny Whitehead, LICSW
• Sara L Wilhelmi, MHT
• Russell Clark Williams Jr., DDS
• Maria Wolf Burdick, LMSW
• Sharon A Wolf, LPN
• Eric Woodard, LAC
• Lorna Denise Youngbird
• Deanna Marie Zander

• Clinical Social Worker in Devils Lake, ND
• Providers in Devils Lake, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2011; 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.