Healthcare Provider Details

I. General information

NPI: 1063332971
Provider Name (Legal Business Name): APRIL WILSON LICENSED CLINICAL SOCIAL WORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 E OCEAN AVE STE E
LOMPOC CA
93436-6926
US

IV. Provider business mailing address

PO BOX 1071
ARROYO GRANDE CA
93421-1071
US

V. Phone/Fax

Practice location:
  • Phone: 805-225-6995
  • Fax:
Mailing address:
  • Phone: 408-466-7245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: APRIL WILSON
Title or Position: THERAPIST
Credential: LCSW
Phone: 408-466-7245