Provider Demographics
NPI:1265786974
Name:WILSON, JOCELYN (LCSW)
Entity type:Individual
Prefix:MS
First Name:JOCELYN
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 1:2603 NORTHRIDGE PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-4046
Mailing Address - Country:US
Mailing Address - Phone:515-338-2929
Mailing Address - Fax:515-337-8863
Practice Address - Street 1:2603 NORTHRIDGE PKWY STE 103
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-4046
Practice Address - Country:US
Practice Address - Phone:515-338-2929
Practice Address - Fax:515-337-8863
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-01
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0155041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical