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

Mr. Jeremy Shane Wilson, CSW, LSW

Individual provider Social Worker · NPI 1245747757

Mr. Jeremy Shane Wilson, CSW, LSW is a Clinical Social Worker in Cincinnati, Ohio. Qualified in 2009, 17 years ago. Practices with Sondermind Provider Network LLC, a 1,258-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
17
Licensed in
OH
In the registry since
2018
What do these letters mean?
LSW — Licensed Social Worker
A state-licensed social worker.

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Practice location Address checks out

5400 Edalbert Dr
Cincinnati, OH 45239-7604
Phone: (859) 536-5808
Fax: (513) 741-5686
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence S.1000131 (OH)

Record details

NPI number1245747757
Entity typeIndividual (Type 1)
GenderMale
Credentials CSW , LSW
Sole proprietorNo
NPI enumeratedJanuary 5, 2018
Last updated in NPPESJanuary 5, 2018

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Sondermind Provider Network Llc — 1258 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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