Theresa O Wilson, LISW-S, SAP
Social Worker, Clinical in Massillon, OH. Individual provider (NPI-1).
NPI number1821362286
StatusActive
Last updated in NPPESFeb 7, 2024
Details
- NPI
- 1821362286
- Entity type
- Individual (NPI-1)
- Name
- Theresa O Wilson
- Credential
- LISW-S, SAP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 2, 2012
- Certification date
- Feb 7, 2024
- Last updated
- Feb 7, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CLINICAL SOCIAL WORKER
- Can order and refer
- Part B No · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | I.1000025-SUPV | OH | Yes |
Practice location
130 1st St NwMassillon, OH 44647-5452
Phone 330-833-0234 · Fax 330-837-7705
Mailing address
625 Cleveland Ave NwCanton, OH 44702-1805
Phone 330-455-0374 · Fax 330-453-6716
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 14 Clinical Social Worker providers in Massillon · All 1,260 providers in Massillon
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