Active NPI
Abigail M Wilson, LCSW
- Social Worker
- Dallas, TX
National Provider Identifier
1740794742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 64274
- Practice address
- 539 W Commerce St # 2751
Dallas, TX 75208-1953 - Phone
- (832) 589-2210
- NPI assigned
- Nov 29, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 64274 | TX | Primary |
Addresses
Primary practice location
539 W Commerce St # 2751
Dallas, TX 75208-1953
Mailing address
539 W Commerce St # 2751
Dallas, TX 75208-1953
Phone (832) 589-2210
Other practice location 1
303 Jackson Hill St
Houston, TX 77007-7407
Phone (281) 200-9120
Other practice location 2
3131 Memorial Ct Apt 6108
Houston, TX 77007-6196
Phone (832) 589-2210
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64274 | TX | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628121600000",
"number": "1740794742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "539 W COMMERCE ST # 2751",
"city": "DALLAS",
"state": "TX",
"postal_code": "752081953",
"telephone_number": "832-589-2210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "539 W COMMERCE ST # 2751",
"city": "DALLAS",
"state": "TX",
"postal_code": "752081953",
"telephone_number": "832-589-2210"
}
],
"practiceLocations": [
{
"address_1": "303 Jackson Hill St",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770077407",
"country_code": "US",
"telephone_number": "281-200-9120",
"fax_number": "281-200-9765",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3131 Memorial Ct Apt 6108",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770076196",
"country_code": "US",
"telephone_number": "832-589-2210",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "ABIGAIL",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-29",
"last_updated": "2021-08-05",
"certification_date": "2021-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TX",
"license": "64274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.