Frazier Clethon Wilson Jr., LISW, LADAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-06709 Issued in NM

Practice address

2418 Miles Rd SE
Albuquerque, NM 87106-3224

Phone

(505) 974-7602

Fax

(505) 842-1503

NPI assigned

Oct 16, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Counseling & Psychotherapy Services, LLC

  • Clinical Social Worker
  • Albuquerque, NM
  • NPI 1417189945
  NPD (past)
• Thomas H Bien LLC

  • Clinical Psychologist
  • Albuquerque, NM
  • NPI 1346768157
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1972683894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 MILES RD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871063224",
            "telephone_number": "505-974-7602",
            "fax_number": "505-842-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 MILES RD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871063224",
            "telephone_number": "505-974-7602",
            "fax_number": "505-842-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "FRAZIER",
        "middle_name": "CLETHON",
        "name_suffix": "Jr.",
        "credential": "LISW, LADAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-06709",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0093531",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "I-06709",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0093531",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra Wilson
• Christopher Gehrig Wilson, M.D.
• Christopher Robert Wilson Jr., PHARMD
• Devin Wilson
• Dierdre Rylene Wilson, MA, LPCC
• Glen P Wilson, M.D.
• Jaron Wilson
• Jason Wilson, MD
• Jennifer Wilson
• Joan Esse Wilson, MS CCC-SLP

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.