Jacob Wiltshire, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P012451 Issued in NC

Practice address

101 E WT Harris Blvd Ste 5500
Charlotte, NC 28262-3485

Phone

(704) 863-5558

Fax

(704) 863-6161

NPI assigned

Jun 26, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1902423924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 ARDMORE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091101",
            "telephone_number": "919-923-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E WT HARRIS BLVD STE 5500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623485",
            "telephone_number": "704-863-5558",
            "fax_number": "704-863-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILTSHIRE",
        "first_name": "JACOB",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "P012451",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P012451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wanda Wilson
• William Barrett Wilson, DDS
• Xavious Wilson, MSW, LCSW
• Kaysie Cheyenne Wilt
• Brandi Wiltshire, DPT
• Vania Wimberly, LCSWA
• Maribeth Wimmer, MACC, LPC
• Jordan Leigh Wimsatt
• Jada D Winchester
• Lundan Allen Winchester

• 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 Jun 26, 2020; 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.