Provider Demographics
NPI:1760155113
Name:WILSON, ARIEL (LCSWA)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12842 DELVIN CASTLE CT
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28134-7342
Mailing Address - Country:US
Mailing Address - Phone:910-977-6209
Mailing Address - Fax:
Practice Address - Street 1:10150 MALLARD CREEK RD STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4507
Practice Address - Country:US
Practice Address - Phone:910-977-6209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical