Provider Demographics
NPI:1104369404
Name:WILKENS, ALEXANDRIA NINA (LCSW)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:NINA
Last Name:WILKENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:ALEXANDRIA
Other - Middle Name:
Other - Last Name:WILKENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:3413 FLAT RIVER DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-7872
Mailing Address - Country:US
Mailing Address - Phone:919-764-2000
Mailing Address - Fax:
Practice Address - Street 1:693 PALMER DRIVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27699-1668
Practice Address - Country:US
Practice Address - Phone:919-855-3430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-18
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0120481041C0700X
NCP0107601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical