Tele Corinne Wilson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

095598 Issued in NY

Practice address

1525 Popham Avenue 1
Bronx, NY 10453-1824

Phone

(929) 356-4341

NPI assigned

Oct 18, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Nouveau Counseling Services, LCSW PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bronx, NY
  • NPI 1063192433
  NPD Authorized official
• Nouveau Counseling Services, LCSW PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bronx, NY
  • NPI 1215715248
  NPD Authorized official

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1811463748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 POPHAM AVENUE 1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104531824",
            "telephone_number": "929-356-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 POPHAM AVENUE 1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104531824",
            "telephone_number": "929-356-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TELE",
        "middle_name": "CORINNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-18",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "104306",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "095598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rushanda Wilson
• Sara Wilson
• Sharmaine Wilson
• Stacy Wilson
• Stephanie Wilson, LCSWR
• Teresa Ann Wilson, CPNP
• Tshura Shantana Wilson, MS, FNP-BC
• Mauricio Wiltz, D.D.S.
• Genesis Kiana Wimmer, RN
• Sheila Wimmer

• Clinical Social Worker in Bronx, NY
• Providers in Bronx, 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 Sep 13, 2023; 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.