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NPI Code Detail

MEDICARE: KATHRYN ANN WILSON LCSW

MEDICARE:   KATHRYN ANN 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
11041C0700XClinical Social WorkerCSW09926974CO
21041C0700XClinical Social Worker17095TX

General Provider Information

NPI Number : 1487037487
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN ANN WILSON LCSW
Provider Business Mailing Address
First Line : 7304 CROSS KEYS DR
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76182-6057
Country : US
Telephone Number : 817-437-7574
Fax Number :
Provider Business Practice Location Address
First Line : 7950 6TH ST
Second Line :
City : WELLINGTON
State : CO
Zip : 80549-1830
Country : US
Telephone Number : 970-888-4070
Fax Number : 970-372-6412
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2015
Last Update Date : 08/31/2021

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Directions to “ KATHRYN ANN WILSON LCSW” Practice Location

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