Charrisse Leiana Wilson, LCSW
NPI 1639853013ActiveIndividual· Social Worker, Clinical· Bloomsburg, PA
Social Worker, Clinical (LCSW) with Supportive Care of Pennsylvania LLC, practicing in Bloomsburg, Pennsylvania. Medicare paid $11,721 for services to 33 patients in 2024.
Overview
| NPI | 1639853013 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW |
| Sole proprietor | Yes |
| NPI issued | Jun 14, 2023 |
| Last updated in NPPES | Jun 14, 2023 |
| Certified by provider | Jun 14, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (PA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 33 |
|---|---|
| Services billed | 217 across 4 procedure codes |
| Paid by Medicare | $11,721 |
Education and affiliations
| Graduation year | 2002 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- Supportive Care of Pennsylvania LLCPhiladelphia, PA · 92 clinicians
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