Individual
MR. JAMES DOUGLAS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
607 BAXTER ST, FAIRVIEW ASSOCIATES, JOHNSON CITY, TN 37601
(423) 232-2720
(423) 928-0381
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3696
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW709
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0128301
MAGELLAN NAVIGATOR
—
01
—
104224
VALUEOPTIONS
—
01
—
1046524
FIRST HEALTH
—
01
—
189387 FVJC
ANTHEM PROF TRIGON
—
01
—
33476
UBH EMPLOYER
—
01
—
334969
VALUEOPTIONS GROUP
—
01
—
55538
CIGNA MCC
—
Enumeration date
08/13/2006
Last updated
07/09/2007
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