Healthcare Provider Details

I. General information

NPI: 1700439072
Provider Name (Legal Business Name): RACHEL LANETT WILSON MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2019
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 THE GRN STE A
DOVER DE
19901-3618
US

IV. Provider business mailing address

8 THE GRN STE A
DOVER DE
19901-3618
US

V. Phone/Fax

Practice location:
  • Phone: 302-278-0013
  • Fax: 302-269-1711
Mailing address:
  • Phone: 302-278-0013
  • Fax: 302-269-1711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0012317
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW024276
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06327200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: