Christina M. Wilson, LMSW-CC – Social Worker

Key facts

NPI: 1922543370
Entity type: Individual (NPI type 1)
Primary specialty: Social Worker 104100000X
License: MC15221 (ME)
Practice address: 474 Main St
Springvale, ME 04083-1409
Phone: (207) 324-1500
Fax: (207) 490-5263
NPI assigned: Dec 21, 2016
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
MC15221	ME	MD	Social Worker

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Social Worker	104100000X	MC15221	ME	Yes

Addresses

Primary practice location

474 Main St
Springvale, ME 04083-1409

Mailing address

300 Southborough Dr
Suite 201
South Portland, ME 04106-6914
Phone (207) 661-2018

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 21, 2016.

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1922543370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SOUTHBOROUGH DR",
            "address_2": "SUITE 201",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066914",
            "telephone_number": "207-661-2018",
            "fax_number": "207-661-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 MAIN ST",
            "city": "SPRINGVALE",
            "state": "ME",
            "postal_code": "040831409",
            "telephone_number": "207-324-1500",
            "fax_number": "207-490-5263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHRISTINA",
        "middle_name": "M.",
        "credential": "LMSW-CC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ME",
            "license": "MC15221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springvale, ME

All providers in Springvale, ME · Social Worker in Maine

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.