Mary Ann Wilson, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

072055 Issued in NY

Practice address

2130 Five Mile Line Rd
Penfield, NY 14526-2292

Phone

(585) 690-0890

NPI assigned

Dec 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Mary Ann Wilson LCSW PLLC

  • Clinical Social Worker
  • Penfield, NY
  • NPI 1992529762
  Medicare reassignment NPD Authorized official
• The Unity Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1760421713
  Medicare reassignment NPD
• Penfield Psychiatry PC

  • Psychiatry Physician
  • Penfield, NY
  • NPI 1649544115
  Medicare reassignment
• The Unity Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1457395766
  NPD

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1760664338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 FIVE MILE LINE RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262292",
            "telephone_number": "585-690-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 FIVE MILE LINE RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262292",
            "telephone_number": "585-690-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARY ANN",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2025-01-13",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "072055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03350007",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David D Williams, M.D.
• Elizabeth F Williams, LMHC
• Mary M Wilsch, M.D.
• Chawanna Nicole Wilson
• Jennifer Wilson, RN
• Allyson Wise, D.O.
• Julie M. Wood, MS, PHD
• Nancy Yani, MD
• Patty Yarmel, PH.D.
• David Ping-Wen Ying, M.D.

• Clinical Social Worker in Penfield, NY
• Providers in Penfield, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.