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

Individual provider Clinical Social Worker · NPI 1639853013

Charrisse Leiana Wilson, LCSW is a Clinical Social Worker in Bloomsburg, Pennsylvania. Qualified in 2002, 24 years ago. Practices with Supportive Care of Pennsylvania LLC, a 93-clinician group and accepts Medicare assignment.

Years since qualifying
24
In the registry since
2023
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

211 E 1st St
Bloomsburg, PA 17815-1405
Phone: (718) 506-1115
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1639853013
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedJune 14, 2023
Last updated in NPPESJune 14, 2023
Certification dateJune 14, 2023

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Supportive Care Of Pennsylvania Llc — 93 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients33
Services billed 217 a service is one billed item, such as a visit, a test or a procedure
Average patient age81

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Colleagues at Supportive Care of Pennsylvania LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 93 clinicians in the practice; 12 are shown here.

Other providers in Bloomsburg