Active NPI
Clea Wilson, LCSW
- Clinical Social Worker
- Bronx, NY
National Provider Identifier
1861637357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 081191-1
- Practice address
- 6355 Broadway
Bronx, NY 10471-2701 - Phone
- (718) 796-4424
- NPI assigned
- Dec 11, 2008
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 081191-1 | NY | Primary |
Addresses
Primary practice location
6355 Broadway
Bronx, NY 10471-2701
Mailing address
5618 Fieldston Rd
Bronx, NY 10471-2507
Phone (718) 450-2002
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
| License | State | Type | Specialty |
|---|---|---|---|
| 081191-1 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380844800000",
"number": "1861637357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5618 FIELDSTON RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104712507",
"telephone_number": "718-450-2002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6355 BROADWAY",
"city": "BRONX",
"state": "NY",
"postal_code": "104712701",
"telephone_number": "718-796-4424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CLEA",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-11",
"last_updated": "2013-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "081191-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.