| Anna H Wilson, Licsw, Pip, Llc | |
|
4268 Cahaba Heights Ct Ste 132 Vestavia AL 35243-5737 | |
| (205) 616-9953 | |
| Not Available |
| Full Name | Anna H Wilson, Licsw, Pip, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4268 Cahaba Heights Ct Ste 132, Vestavia, Alabama |
| Authorized Official Name and Position | Anna H Wilson (SOLE OWNER AND OPERATOR) |
| Authorized Official Contact | 2056169953 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anna H Wilson, Licsw, Pip, Llc 3050 Teresa Ave Hueytown AL 35023-3043 Ph: (205) 616-9953 | Anna H Wilson, Licsw, Pip, Llc 4268 Cahaba Heights Ct Ste 132 Vestavia AL 35243-5737 Ph: (205) 616-9953 |
| NPI Number | 1669131199 |
|---|---|
| Provider Enumeration Date | 12/13/2021 |
| Last Update Date | 12/13/2021 |
| Certification Date | 12/13/2021 |
| Medicare PECOS PAC ID | 7810383940 |
|---|---|
| Medicare Enrollment ID | O20220329002642 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669131199 | NPI | - | NPPES |
| 1922024064 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Anna H Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922124064 PECOS PAC ID: 8426149436 Enrollment ID: I20070806000559 |
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