Lee Avery Wilson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C011958 Issued in NC

Practice address

1021 Morehead Medical Dr Ste 5004
Charlotte, NC 28204-2990

Phone

(980) 442-5136

Fax

(980) 442-5131

NPI assigned

Dec 22, 2023

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1703203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1891564571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 12TH ST NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286012771",
            "telephone_number": "828-217-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 MOREHEAD MEDICAL DR STE 5004",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042990",
            "telephone_number": "980-442-5136",
            "fax_number": "980-442-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LEE",
        "middle_name": "AVERY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-22",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Comolli Wilson, MD
• Kelsi Wilson, LMFT
• Kennedy Grace Wilson
• Kimberly Lannette Wilson, LMFT
• Lamar Wilson
• Lindsey Elise Wilson, MD
• Lisa Kay Wilson, MD
• Lori Ann Wilson, RESPIRATORY THERAPY
• Megan Nicole Wilson, NP-C
• Michael B. Wilson, MD

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.