Active NPI
Jonathan Wilson, LCSW
- Clinical Social Worker
- Lakeville, CT
National Provider Identifier
1982365771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 005223
- Practice address
- 327 Main St
Lakeville, CT 06039-1205 - Phone
- (860) 435-2210
- NPI assigned
- Jan 4, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 005223 | CT | Primary |
Addresses
Primary practice location
327 Main St
Lakeville, CT 06039-1205
Mailing address
PO Box 661
Lakeville, CT 06039-0661
Phone (860) 491-5605
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 |
|---|---|---|---|
| 005223 | CT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641254400000",
"number": "1982365771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 661",
"city": "LAKEVILLE",
"state": "CT",
"postal_code": "060390661",
"telephone_number": "860-491-5605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "327 MAIN ST",
"city": "LAKEVILLE",
"state": "CT",
"postal_code": "060391205",
"telephone_number": "860-435-2210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JONATHAN",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-04",
"last_updated": "2022-01-04",
"certification_date": "2022-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "005223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeville, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.