Provider Demographics
NPI:1619230182
Name:WILSON, CARMEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 480
Mailing Address - Street 2:BOX 664
Mailing Address - City:STUTTGART
Mailing Address - State:GERMANY
Mailing Address - Zip Code:09128
Mailing Address - Country:DE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6451 SPECKER RD BLDG 1830
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:80913
Practice Address - Country:US
Practice Address - Phone:719-526-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical