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Physician Compare National (NPI:1528287018)

HEALTHCARE PROVIDER: VICKIE L WOOD LCSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1528287018
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 0042307563
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20080919000030
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name WOOD
Individual professional last name
Provider First Name VICKIE
Individual professional first name
Provider Middle Name L
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2004
Individual professional's medical school graduation year
Primary Specialty CLINICAL SOCIAL WORKER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name PIONEER COUNSELING SERVICES
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 8426030156
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 2
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 350 CITY VIEW DR
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 206
Group Practice or individual's line 2 address
City EVANSTON
Group Practice or individual's city
State WY
Group Practice or individual's state
Zip Code 829305326
Group Practice or individual's zip code (9 digits when available)
Phone Number 3077897915
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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