Individual provider · Type 1 NPI

Thomas Theodore Wilson, LCSW

Clinical Social Worker · Rochester, NY

NPI number 1083465264 Active

Practice location

1381 E Ridge Rd Ste 5
Rochester, NY 14621-2019

Call (585) 922-2500 Map

Fax (585) 922-2710

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X101271 (NY)
Clinical Social Worker 1041C0700X116209 (CA)

Clinical Social Worker: 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 interpers…

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About NPI 1083465264

Thomas Theodore Wilson, LCSW's National Provider Identifier is 1083465264, issued on Mar 27, 2024. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Rochester, NY. The record was last updated on Aug 5, 2026.