Active NPI
Selena Lee Wilson
- Social Worker
- Richmond, TX
National Provider Identifier
1942075528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 63815
- Practice address
- 7718 Millstone Trail LN # NA
Richmond, TX 77469-3757 - Phone
- (832) 558-1409
- NPI assigned
- Nov 23, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 9115 | OK | |
| Social Worker | 104100000X | 63815 | TX | Primary |
Addresses
Primary practice location
7718 Millstone Trail LN # NA
Richmond, TX 77469-3757
Mailing address
PO Box 44
Okmulgee, OK 74447-0044
Phone (713) 865-6787
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 |
|---|---|---|---|
| 63815 | TX | MD | Social Worker |
| 9115 | OK | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722988800000",
"number": "1942075528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 44",
"city": "OKMULGEE",
"state": "OK",
"postal_code": "744470044",
"telephone_number": "713-865-6787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7718 MILLSTONE TRAIL LN # NA",
"city": "RICHMOND",
"state": "TX",
"postal_code": "774693757",
"telephone_number": "832-558-1409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SELENA",
"middle_name": "LEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-23",
"last_updated": "2024-08-07",
"certification_date": "2024-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OK",
"license": "9115",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TX",
"license": "63815",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.