Provider Demographics
NPI:1164014320
Name:WILK, CHRISTINA ANN (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:ANN
Last Name:WILK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 S HIGHLAND AVE APT 4C
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-5837
Mailing Address - Country:US
Mailing Address - Phone:631-680-6936
Mailing Address - Fax:
Practice Address - Street 1:117 S HIGHLAND AVE
Practice Address - Street 2:APT 4C
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562
Practice Address - Country:US
Practice Address - Phone:631-680-6936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091175104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker