Mary Ann Wilson LCSW PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MARY ANN WILSON LCSW PLLC

Practice address

2130 Five Mile Line Rd
Penfield, NY 14526-2292

Phone

(585) 270-1119

NPI assigned

Nov 8, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Mary Ann WilsonNPI 1760664338

Title

LCSW PLLC

Phone

(585) 690-0890

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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.

• Mary Ann Wilson, LCSW-R

  • Clinical Social Worker
  • Penfield, NY
  • NPI 1760664338
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1731024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731024000000",
    "number": "1992529762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 RIDGEMONT DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146263444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 FIVE MILE LINE RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262292",
            "telephone_number": "585-270-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ANN WILSON LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-08",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "LCSW PLLC",
        "authorized_official_telephone_number": "585-690-0890",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa J Maher, RN LMSW
• Elizabeth Makar-Piczko, RPA-C
• Stephanie Malone, OT
• Hayley Mandel, LMHC
• Manual Physical Therapy Specialists PLLC
• Frank Dominic Massaro, DDS
• Erin Mast
• Michael Anthony Mastrodonato II, DC
• Kayleigh Matesic, PHARMD
• Fletcher Reid Matthes, L.M.T.

• Clinical Social Worker in Penfield, NY
• Providers in Penfield, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.