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

Kelly Kendra Wilson, LCSW

Individual provider Clinical Social Worker · NPI 1902345416

Kelly Kendra Wilson, LCSW is a Clinical Social Worker in Fayetteville, Arkansas. Qualified in 2016, 10 years ago. Accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
10
Licensed in
AR
In the registry since
2017
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3162 W Martin Luther King Blvd Ste 13-14
Fayetteville, AR 72704-7679
Phone: (479) 935-4834
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 8293-C (AR)
Clinical Social Worker Taxonomy 1041C0700X · Licence 8293-M (AR)

Record details

NPI number1902345416
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedFebruary 16, 2017
Last updated in NPPESJune 8, 2020
Certification dateJune 8, 2020

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fayetteville