MS. SHANNON AMBER WILSON (NPI# 1013225754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013225754 |
| Entity Type | Individual |
| Full Name | MS. SHANNON AMBER WILSON |
| Credential | LCSW |
| Practice Address |
3535 N California Ave Suite F Peoria IL 61603-1178 |
| Mailing Address |
1215 Royal Pointe Dr Bloomington IL 61704-8213 |
| Practice Telephone | 3096862153 |
| Practice Fax Number | 8883716976 |
| Mailing Telephone | 2697534826 |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2012-09-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149015191 | IL | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
MC12620 | ME | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841752425 | Shannon Michelle Wilson | Licensed Practical Nurse | 38 S Thomas Rd Unit B, Tallmadge, OH 44278-2100 | 2019-04-03 |
| 1336617398 | Shannon Wilson | Registered Nurse | 228 19th St Sw, Rochester, MN 55902-2327 | 2018-11-07 |
| 1841711173 | Shannon Wilson | Physical Therapy Assistant | 6102 Easton Rd, Knoxville, TN 37920-6434 | 2017-06-27 |
| 1629417746 | Shannon Marie Wilson | Counselor | 1570 42nd St Ne Ste 2a, Cedar Rapids, IA 52402-3073 | 2013-06-21 |
| 1033402268 | Shannon Lotess Wilson | Licensed Practical Nurse | 16834 127th Ave, 6a, Jamaica, NY 11434-3148 | 2011-05-20 |
| 1043413115 | Shannon Leigh Wilson | Physical Therapy Assistant | 5210 Sarah Lane, Fredericksburg, VA 22407 | 2007-06-07 |
| 1477681146 | Shannon Brock Wilson | Dentist | 19 Shirmadon Dr, Honea Path, SC 29654-1533 | 2007-03-02 |
| 1730714320 | Shannon Elise Wilson | Behavior Technician | 5333 Mission Center Rd Ste 110, San Diego, CA 92108-1347 | 2020-03-04 |
| 1396225843 | Shannon A Wilson | Behavior Technician | 2733 Quarry Heights Way, Baltimore, MD 21209-1080 | 2018-08-15 |
| 1003304171 | Shannon Wilson | Assistant Behavior Analyst | 550 N Reo St, Tampa, FL 33609-1061 | 2018-04-24 |
| Street Address |
3535 N CALIFORNIA AVE SUITE F |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-1178 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447857305 | Kelsey Hardy | Social Worker | 306 Pecan St, Peoria, IL 61602-1662 | 2020-10-05 |
| 1821608985 | Jozie Allen | Social Worker | 1001 Main St Ste 107, Peoria, IL 61606-1907 | 2020-08-04 |
| 1811533276 | Portia Elizabeth Adams | Social Worker | 712 E War Memorial Dr, Peoria, IL 61616-7548 | 2019-11-20 |
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1205498573 | Leith Elan Bucher | Social Worker | 1801 W Gardenia Dr Apt 13312, Peoria, IL 61615-7098 | 2019-07-08 |
| 1568934107 | Earthwalk Wellness Group, LLC | Social Worker | 14050 North 83rd Avenue, Suite 290, Peoria, AZ 85381 | 2018-12-20 |
| 1568934164 | Venus E Evans-winters | Social Worker | 4507 N Sterling Ave Ste 201, Peoria, IL 61615-3861 | 2018-12-19 |
| 1700301058 | Lisa Gail Childers | Social Worker | 508 W Timber Ridge Dr, Peoria, IL 61615-2057 | 2017-08-08 |
| 1538608690 | Phoenix Wellness, LLC | Social Worker | 2020 W War Memorial Dr, Ste 304, Peoria, IL 61614-6754 | 2017-02-21 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.