Active NPI
Julie Wilner, LMSW
- Social Worker
- Canandaigua, NY
National Provider Identifier
1740394915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 065507
- Practice address
- 3019 County Complex Dr
Canandaigua, NY 14424-9505 - Phone
- (585) 396-4363
- Fax
- (585) 396-4993
- NPI assigned
- Aug 18, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 065507 | NY | Primary |
Addresses
Primary practice location
3019 County Complex Dr
Canandaigua, NY 14424-9505
Mailing address
18 West St Apt 4
Fairport, NY 14450-2110
Phone (585) 377-7006
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3109089 | Other | NY | VALUE OPTIONS |
| 103283EU | Other | NY | PREFERRED CARE |
| EM | Other | NY | EXCELLUS |
| 07200065507 | Medicaid | NY |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 065507 | NY | MD | Pharmacy |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1740394915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 WEST ST APT 4",
"city": "FAIRPORT",
"state": "NY",
"postal_code": "144502110",
"telephone_number": "585-377-7006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3019 COUNTY COMPLEX DR",
"city": "CANANDAIGUA",
"state": "NY",
"postal_code": "144249505",
"telephone_number": "585-396-4363",
"fax_number": "585-396-4993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILNER",
"first_name": "JULIE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "065507",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "3109089",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "103283EU",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EXCELLUS",
"identifier": "EM",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07200065507",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Canandaigua, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.