Kelly Margaret Wilson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

105803 Issued in CA

Practice address

1667 S Mission Rd Ste C
Fallbrook, CA 92028-4113

Phone

(760) 505-0570

NPI assigned

Aug 30, 2019

Sex

Female

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

Opted out of Medicare

Yes, effective Feb 1, 2025 through Feb 1, 2027

Medicare enrollment (NPD)

Not 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.

• Encouragers Counseling and Training Centers, Inc

  • Group Psychotherapy Psychologist
  • Murrieta, CA
  • NPI 1194120287
  NPD (past)

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1881242956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 GIRD RD",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920289687",
            "telephone_number": "760-505-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1667 S MISSION RD STE C",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920284113",
            "telephone_number": "760-505-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KELLY",
        "middle_name": "MARGARET",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-30",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "105803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Westholm
• David Louis Wetzel, D.C.
• Jessica Lyn White, MS
• Kenneth Wiggins
• Sharna R Williams, CNM/ NP
• Jeffrey P Winick, M.D.
• Gernot Hagen Winkler, DDS
• Frank Winton, M.D
• Without Limits Physical Therapy and Wellness
• Frank J Witt, DPM

• Clinical Social Worker in Fallbrook, CA
• Providers in Fallbrook, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.