Provider Demographics
NPI:1033995501
Name:WILKES, NAKIA MARIE (ICADC, CADC)
Entity Type:Individual
Prefix:MRS
First Name:NAKIA
Middle Name:MARIE
Last Name:WILKES
Suffix:
Gender:F
Credentials:ICADC, CADC
Other - Prefix:MS
Other - First Name:NAKIA
Other - Middle Name:MARIE
Other - Last Name:HURDLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ICADC, CADC
Mailing Address - Street 1:418 SUGAR COVE RUN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411
Mailing Address - Country:US
Mailing Address - Phone:910-659-4299
Mailing Address - Fax:910-319-0736
Practice Address - Street 1:418 SUGAR COVE RUN
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411
Practice Address - Country:US
Practice Address - Phone:910-659-4299
Practice Address - Fax:910-319-0736
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27176101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)