Active NPI
Marissa Jeanne Wilson, MSW, LCSWA
- Clinical Social Worker
- Greensboro, NC
National Provider Identifier
1881405702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P021684
- Practice address
- 5 Oak Branch Dr Ste H
Greensboro, NC 27407-2157 - Phone
- (336) 288-9190
- Fax
- (336) 450-4318
- NPI assigned
- Jan 20, 2025
- Last updated
- Jan 20, 2025
- 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 | P021684 | NC | Primary |
Addresses
Primary practice location
5 Oak Branch Dr Ste H
Greensboro, NC 27407-2157
Mailing address
1837 Neelley Rd
Pleasant Garden, NC 27313-9227
Phone (336) 479-3301
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P021684 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tree of Life Counseling, PLLC | Clinical | Current | Accepting new patients |
Locations
5 Oak Branch Dr
Ste H
Greensboro, NC 27407
Phone (336) 288-9190
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737331200000",
"number": "1881405702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1837 NEELLEY RD",
"city": "PLEASANT GARDEN",
"state": "NC",
"postal_code": "273139227",
"telephone_number": "336-479-3301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 OAK BRANCH DR STE H",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274072157",
"telephone_number": "336-288-9190",
"fax_number": "336-450-4318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MARISSA",
"middle_name": "JEANNE",
"credential": "MSW, LCSWA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-20",
"last_updated": "2025-01-20",
"certification_date": "2025-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P021684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.