Provider Demographics
NPI:1043262231
Name:WILKERSON, HEATHER MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:WILKERSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8715 ARABIA RD
Mailing Address - Street 2:
Mailing Address - City:LUMBER BRIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:28357-9661
Mailing Address - Country:US
Mailing Address - Phone:910-494-5888
Mailing Address - Fax:910-848-0843
Practice Address - Street 1:8715 ARABIA RD
Practice Address - Street 2:
Practice Address - City:LUMBER BRIDGE
Practice Address - State:NC
Practice Address - Zip Code:28357-9661
Practice Address - Country:US
Practice Address - Phone:910-494-5888
Practice Address - Fax:910-848-0843
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0052441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical