Individual provider Active NPI

Caitlin Grace Wilson, LCSW

  • Clinical Social Worker
  • Troy, NY
National Provider Identifier
1750944906
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
099136 Issued in NY
Practice address
2215 Burdett Ave
Troy, NY 12180-2466
Phone
(518) 883-6470
Fax
(518) 271-3682
NPI assigned
Apr 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 099136 NY Primary
Social Worker 104100000X 103559-1 NY

Addresses

Primary practice location

2215 Burdett Ave
Troy, NY 12180-2466

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other practice location 1

191 Bethpage Sweet Hollow Rd
Old Bethpage, NY 11804-1342
Phone (516) 870-1600 ext. 1778

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250428002451 NY Practitioner - Clinical Social Worker 0042736506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Family Counseling Center of Fulton County IncGroup PAC ID 0042283335, 14 clinicians

Practice addresses (Care Compare)

11 -21 Broadway St
Gloversville, NY 12078-3968
Phone (518) 725-4310

Hospital & facility affiliations

  • Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
099136NYMDSocial Worker
103559-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York Clinical CurrentSince May 12, 2025 Accepting new patients

Locations

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1750944906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 BURDETT AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802466",
            "telephone_number": "518-883-6470",
            "fax_number": "518-271-3682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "191 Bethpage Sweet Hollow Rd",
            "address_purpose": "LOCATION",
            "city": "Old Bethpage",
            "state": "NY",
            "postal_code": "118041342",
            "country_code": "US",
            "telephone_number": "516-870-1600 x1778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CAITLIN",
        "middle_name": "GRACE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "099136",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "103559-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2215 Burdett Ave",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121802466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

Verify at the official NPI Registry.