Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jordan R Wilson, LICSW

Individual provider Clinical Social Worker · NPI 1346898111

Jordan R Wilson, LICSW is a Clinical Social Worker in Boston, Massachusetts. Qualified in 2014, 12 years ago. Practices with Fenway Community Health Center, Inc, a 81-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona and Massachusetts.

Years since qualifying
12
Licensed in
AZ, MA
In the registry since
2019
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

1340 Boylston St
Boston, MA 02215-4302
Phone: (617) 247-7555
Fax: (617) 262-0872
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4909 E McDowell Rd, Phoenix, AZ 85008-4227 — (602) 685-6000

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 122541 (MA)
Clinical Social Worker Taxonomy 1041C0700X · Licence LCSW-18006 (AZ)

Record details

NPI number1346898111
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedAugust 26, 2019
Last updated in NPPESDecember 12, 2024
Certification dateDecember 12, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Fenway Community Health Center, Inc — 81 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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