KELLY KENDRA WILSON LCSW
NPI 1902345416
Social Worker - Clinical in Fayetteville, AR

Active since February 16, 2017PECOS EnrolledAccepts Medicare Assignment
3162 W MARTIN LUTHER KING BLVD STE 13-14, FAYETTEVILLE, AR 72704(479) 935-4834 Get Directions Write a Review

NPPES record last updated: June 8, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 8, 2020, Feb 17, 2017 (2 updates tracked since 2017).

About Kelly Kendra Wilson Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY KENDRA WILSON LCSW (NPI 1902345416) is an individual clinical provider in Fayetteville, Arkansas, licensed in Arkansas (8293-C) and active in the NPI registry since February 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1902345416
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKELLY KENDRA WILSONCredential: LCSW
Location Address3162 W MARTIN LUTHER KING BLVD STE 13-14Fayetteville, AR 72704-7679
Mailing Address614 E Emma Ave Ste 300Springdale, AR 72764-4469 · (479) 751-7417 · Fax (479) 751-4898
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateFebruary 16, 2017
Last NPPES UpdateJune 8, 20202 updates tracked since enumeration
NPPES CertifiedJune 8, 2020
NPI 1902345416 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses Licensed in AR · 8293-C Licensed in AR · 8293-M
Definition

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.

3162 W MARTIN LUTHER KING BLVD STE 13-14, Fayetteville, AR 72704

Other Names 1

Former Name (1)Kelly White Lmsw

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Kelly Kendra Wilson Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6901228964
PECOS Enrollment IDI20200619000856
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72704 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $51.36 – $157.74
Typical copayment $0.00 (range $12.84 – $39.43)
Most-billed visit code NA
Established Patient
$64.56 typical visit price
range $16.16 – $128.77
Typical copayment $16.14 (range $4.04 – $32.19)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
3162 W MARTIN LUTHER KING BLVD STE 13-14
FAYETTEVILLE, AR 72704

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1902345416, enumerated as an "individual" on February 16, 2017.

The provider is located at 3162 W MARTIN LUTHER KING BLVD STE 13-14 FAYETTEVILLE, AR 72704 and the phone number is (479) 935-4834.

Social Worker with taxonomy code 1041C0700X and a focus in Clinical.

The provider might be accepting Accepts: Arkansas Blue Cross and Blue Shield, Health. Please consult your insurance carrier or call the provider to verify.