Individual provider Active NPI

Julie Wilner, LMSW

  • Social Worker
  • Canandaigua, NY
National Provider Identifier
1740394915
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
065507 Issued in NY
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

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3109089OtherNYVALUE OPTIONS
103283EUOtherNYPREFERRED CARE
EMOtherNYEXCELLUS
07200065507MedicaidNY

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

LicenseStateTypeSpecialty
065507NYMDPharmacy

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.

Verify at the official NPI Registry.