Individual provider Active NPI

Anna Heaton Wilson, LCSW, PIP

  • Clinical Social Worker
  • Huntsville, AL
National Provider Identifier
1922124064
Registry record updated Aug 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0817-2059C Issued in AL
Practice address
111 Longwood Drive
Huntsville, AL 35801-4522
Phone
(256) 534-8161
Fax
(256) 534-7254
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2059C AL
Clinical Social Worker 1041C0700X 0817-2059C AL Primary

Addresses

Primary practice location

111 Longwood Drive
Huntsville, AL 35801-4522

Mailing address

111 Longwood Drive
Huntsville, AL 35801-4522
Phone (256) 534-8161

Other names 1

  • Mrs. Anna Heaton Henry Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070806000559 AL Practitioner - Clinical Social Worker 8426149436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4 Office Park Cir
Suite 113
Mountain BRK, AL 35223-2630
Phone (205) 616-9953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0817-2059CALMDClinical Social Worker
2059CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
SVPS Psychiatric Services LLC Past Accepting new patients
Wilson Counseling & Assessment PastSince May 1, 2022 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282521600000",
    "number": "1922124064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 LONGWOOD DRIVE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014522",
            "telephone_number": "256-534-8161",
            "fax_number": "256-534-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 LONGWOOD DRIVE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014522",
            "telephone_number": "256-534-8161",
            "fax_number": "256-534-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ANNA",
        "middle_name": "HEATON",
        "name_prefix": "Mrs.",
        "credential": "LCSW, PIP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2010-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "2059C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "0817-2059C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "HENRY",
            "middle_name": "HEATON",
            "prefix": "MRS.",
            "credential": "LCSW, PIP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.