Jason M Wildman

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

081674 Issued in NY

Practice address

50 W 23Rd St
9TH Floor
New York, NY 10010-5205

Phone

(212) 989-2990

Fax

(212) 792-6058

NPI assigned

Sep 16, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1851624308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 W 106TH ST",
            "address_2": "7B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100253620",
            "telephone_number": "917-715-6664",
            "fax_number": "212-792-6058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W 23RD ST",
            "address_2": "9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100105205",
            "telephone_number": "212-989-2990",
            "fax_number": "212-792-6058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDMAN",
        "first_name": "JASON",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-16",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melvyn Wilder Jr., CASAC
• Wildflower Telehealth Network Inc.
• Melody Wilding, LMSW
• Jesse McGraw Wildman Foster, LMFT
• Horatio F. Wildman, M.D.
• Linda Levine Wildman, REGISTERD DIETITIAN
• Nancy Hill Wildrick, LCSW
• Nailah L Wilds, LCAT, R-DMT
• Nicole Joy Wildstein, PSY.D.
• Abigail Wile, LCSW

• Clinical Social Worker in New York, NY
• Providers in New York, 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 Mar 27, 2014; 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.