National Provider Identifier
Thomas Theodore Wilson, LCSW
Thomas Theodore Wilson, LCSW is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Rochester, NY and a listed phone number of (585) 922-2500.
Profile Overview
- NPI
- 1083465264
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- March 27, 2024
- Last Updated
- February 13, 2026
Practice Location
- 490 E Ridge RD
- Rochester, NY 14621-1297
Phone: (585) 922-2500
Specialties
- Clinical Social Worker (1041C0700X)
- Clinical Social Worker (1041C0700X)
Full Record
- NPI
- 1083465264
- Entity Type
- Individual
- Last Name
- Wilson
- First Name
- Thomas
- Middle Name
- Theodore
- Credential
- LCSW
- Mailing Street Address
- 490 E Ridge RD
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14621-1297
- Mailing Country
- US
- Mailing Phone
- (315) 569-0809
- Practice Street Address
- 490 E Ridge RD
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621-1297
- Practice Country
- US
- Practice Phone
- (585) 922-2500
- Enumeration Date
- March 27, 2024
- Last Updated
- February 13, 2026
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- February 13, 2026
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X), Clinical Social Worker (1041C0700X)