MEDICARE: SUSANA WILSON LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	34006913A	IN

General Provider Information

NPI Number	:	1336565761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSANA WILSON LCSW

Provider Business Mailing Address
First Line	:	6626 E 75TH ST
Second Line	:	SUITE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2805
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2040 N SHADELAND AVE
Second Line	:	STE 250
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-1711
Country	:	US
Telephone Number	:	317-355-5009
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2014
Last Update Date	:	05/08/2018

Similar Medicare Providers

1225385651 — JENNIFER L O'NEAL LMHC
Practice Location Address:

2040 N SHADELAND AVE , SUITE 200
INDIANAPOLIS, IN
46219-1711

Practice Phone: 317-355-1800
Practice Fax: 317-355-1803

1821016700 — CHRIS DIEDERICH LCSW
Practice Location Address:

2040 N SHADELAND AVE , STE 250
INDIANAPOLIS, IN
46219-1711

Practice Phone: 317-355-5009
Practice Fax:

1922178516 — COMMUNITY HOSPITALS OF INDIANA INC
Practice Location Address:

2040 N SHADELAND AVE , SUITE 300
INDIANAPOLIS, IN
46219-1711

Practice Phone: 317-355-2122
Practice Fax: 317-355-6042

1477626398 — COMMUNITY HOSPITALS OF INDIANA INC
Practice Location Address:

2040 N SHADELAND AVE , SUITE 300
INDIANAPOLIS, IN
46219-1711

Practice Phone: 317-355-3232
Practice Fax: 317-355-6042

1336419894 — BRIDGETTE E MCLAURIN LMHC,LCAC
Practice Location Address:

2040 N SHADELAND AVE , SUITE 200
INDIANAPOLIS, IN
46219-1711

Practice Phone: 317-355-1800
Practice Fax: 317-355-1803

1295001329 — TEYKIA ELICE DEVEAUX MD
Practice Location Address:

2040 N SHADELAND AVE
INDIANAPOLIS, IN
46219-1711

Practice Phone: 317-355-2121
Practice Fax:

Directions to “ SUSANA WILSON LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.