Active NPI
Lisa Renee Wilson, LCSW
- Social Worker
- Ocala, FL
National Provider Identifier
1790905008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SW 10251
- Practice address
- 2091 NE 35TH St
Ocala, FL 34479-2909 - Phone
- (352) 732-1355
- NPI assigned
- Apr 27, 2007
- 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 | SW 10251 | FL | Primary |
Addresses
Primary practice location
2091 NE 35TH St
Ocala, FL 34479-2909
Mailing address
PO Box 685
Citra, FL 32113
Phone (352) 425-8454
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 766681100 | Medicaid | FL |
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 |
|---|---|---|---|
| SW 10251 | FL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365638400000",
"number": "1790905008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 685",
"city": "CITRA",
"state": "FL",
"postal_code": "32113",
"telephone_number": "352-425-8454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2091 NE 35TH ST",
"city": "OCALA",
"state": "FL",
"postal_code": "344792909",
"telephone_number": "352-732-1355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "LISA",
"middle_name": "RENEE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-27",
"last_updated": "2013-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "FL",
"license": "SW 10251",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "766681100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ocala, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.