Individual
EBONY N WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSWA
Contact information
Practice address
10130 MALLARD CREEK RD STE 300, CHARLOTTE, NC 28262-6001
(980) 382-2328
Mailing address
10014 RED BLUFF CT, CHARLOTTE, NC 28269-8381
(704) 890-5562
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
P013694
NC
1041C0700X
Clinical Social Worker
Primary
P013694
NC
1041C0700X
Clinical Social Worker
Primary
P022344
NC
Other
Enumeration date
10/22/2019
Last updated
02/26/2026
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