Mindy Wilkerson, LCSW, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MINDY WILKERSON, LCSW, PLLC

Practice address

19 E Mountain St
Fayetteville, AR 72701-6067

Phone

(479) 222-1671

NPI assigned

Nov 13, 2020

Organization subpart

No

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

Authorized official

Name

Mindy Wilkerson, LCSWNPI 1396283875

Title

Mental Health Therapist

Phone

(314) 922-4558

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mindy Wilkerson, LCSW

  • Social Worker
  • Fayetteville, AR
  • NPI 1396283875

  Clinical

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1605225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605225600000",
    "number": "1952903973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22578 OAKVIEW RD",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727618246",
            "telephone_number": "314-922-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 E MOUNTAIN ST",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727016067",
            "telephone_number": "479-222-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDY WILKERSON, LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-13",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "MINDY",
        "authorized_official_title_or_position": "MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "314-922-4558",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1396283875",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Breanna Mills, APRN, FNP-C
• Stacie M Mills
• Mary Grace Millwee, PHARM.D.
• Paul Benjamin Mincy, LCSW
• Mindful Futures LLC
• Juliette Smith Minkel, MS, M.ED, LPC,RPT-S
• Mission Family Practice PLLC
• Banford Raye Mitchell, M.D.
• Brittney Mitchell
• Elias Mahon Mitchell, MD

• Clinical Social Worker in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.