JACQUELINE HOLLEY WILSON
NPI 1740846039
Social Worker - Clinical in Buford, GA
NPI Status: Active since May 13, 2019
Contact Information
4305 S LEE ST STE 500
BUFORD, GA
ZIP 30518
Phone: (678) 602-9229
Fax: (770) 995-1959
- Individual
- Female
- Social Worker
- Clinical
- Opted-Out Medicare
About JACQUELINE WILSON
This page provides the complete NPI Profile along with additional information for Jacqueline Wilson, a provider established in Buford, Georgia with a medical specialization in Social Worker, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1740846039 assigned on May 2019. The practitioner's primary taxonomy code is 1041C0700X. The provider is registered as an individual and her NPI record was last updated 3 years ago.
- NPI
- 1740846039
- Provider Name
- JACQUELINE HOLLEY WILSON
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 4305 S LEE ST STE 500 BUFORD, GA 30518
- Location Phone
- (678) 602-9229
- Location Fax
- (770) 995-1959
- Mailing Address
- 3644 BUTTERCUP CT BUFORD, GA 30519
- Mailing Phone
- (678) 602-9229
- Mailing Fax
- (770) 995-1959
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-13-2019
- Last Update Date
- 10-17-2023
- Code Navigator
A clinical social worker like Jacqueline Wilson is licensed to diagnose and treat mental, behavioral, and emotional disorders. A clinical social worker helps patients develop strategies to change behavior or cope with difficult situations and refer patients to other resources or services, such as support groups or other mental health professionals.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Jacqueline Wilson opted out of Medicare effective on 01-16-2024 until 01-16-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Social Worker Clinical
- Taxonomy Code
- 1041C0700X
- Type
- Behavioral Health & Social Service Providers
- Taxonomy Description
- 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.
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 01-16-2024
Opt-Out End Date: 01-16-2026
Eligible to Order and Refer? No
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1740846039, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1740846039, enumerated as an "individual" on May 13, 2019.
The provider is located at 4305 S LEE ST STE 500 BUFORD, GA 30518 and the phone number is (678) 602-9229.
Social Worker with taxonomy code 1041C0700X and a focus in Clinical.
