Individual provider Active NPI

Christina L Wilson, LQP, MSW, LCSW, LCAS

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1801233937
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C009526 Issued in NC
Practice address
2670 Durham Chapel Hill Blvd
Durham, NC 27707-2829
Phone
(919) 251-9001
Fax
(919) 251-9008
NPI assigned
May 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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 C009526 NC Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS - 20100 NC

Addresses

Primary practice location

2670 Durham Chapel Hill Blvd
Durham, NC 27707-2829

Mailing address

2670 Durham Chapel Hill Blvd
Durham, NC 27707-2829
Phone (919) 251-9001

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
LCAS - 20100NCMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1801233937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 DURHAM CHAPEL HILL BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072829",
            "telephone_number": "919-251-9001",
            "fax_number": "919-251-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 DURHAM CHAPEL HILL BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072829",
            "telephone_number": "919-251-9001",
            "fax_number": "919-251-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHRISTINA",
        "middle_name": "L",
        "credential": "LQP, MSW, LCSW, LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009526",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS - 20100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; 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.