Individual provider Active NPI

Marsha Wilkinson, LCSW

  • Clinical Social Worker
  • Powell, WY
National Provider Identifier
1730150335
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW617 Issued in WY
Practice address
125 S Division St
Powell, WY 82435-2409
Phone
(307) 754-7970
NPI assigned
Jan 31, 2006
Last updated
Dec 11, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCSW617 WY
Clinical Social Worker 1041C0700X 47649983501 UT
Clinical Social Worker 1041C0700X LCSW617 WY Primary

Addresses

Primary practice location

125 S Division St
Powell, WY 82435-2409

Mailing address

529 Road 9
Powell, WY 82435-9725
Phone (801) 205-5275

Other identifiers 2

IdentifierTypeStateIssuer
1730150335MedicaidWY
1730150335OtherINSURANCE

Other names 1

  • Ooo Ooo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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

Enrollment IDStateProvider typePAC IDDetails
I20180126000188 WY Practitioner - Clinical Social Worker 8426317199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

507 N Clark St
Powell, WY 82435-1915
Phone (307) 754-7970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW617WYMDMental Health Counselor
47649983501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Progressions, LLC Clinical CurrentSince Jan 10, 2018 Accepting new patients
Chrysalis Treatment Center, Inc. PastSince Jan 10, 2018 Accepting new patients

Locations

507 N Clark St
Powell, WY 82435
Phone (307) 754-7970

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1730150335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 ROAD 9",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824359725",
            "telephone_number": "801-205-5275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S DIVISION ST",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824352409",
            "telephone_number": "307-754-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "MARSHA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WY",
            "license": "LCSW617",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "47649983501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730150335",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE",
            "identifier": "1730150335",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OOO",
            "last_name": "OOO",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Powell, WY

Sources for this page

Verify at the official NPI Registry.