Provider Demographics
NPI:1033407267
Name:WILCOXON, SHIRLEY ELAINE (LPC)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:ELAINE
Last Name:WILCOXON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 MCGEE ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64106-2416
Mailing Address - Country:US
Mailing Address - Phone:816-418-7000
Mailing Address - Fax:
Practice Address - Street 1:1211 MCGEE ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64106-2416
Practice Address - Country:US
Practice Address - Phone:816-418-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009002731101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional