Provider Demographics
NPI:1164124533
Name:WILKINSON, KAYLA (LCSW)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:WILKINSON
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 1:8122 NE COUNTY ROAD 1040
Mailing Address - Street 2:
Mailing Address - City:RICE
Mailing Address - State:TX
Mailing Address - Zip Code:75155-3708
Mailing Address - Country:US
Mailing Address - Phone:903-641-9451
Mailing Address - Fax:
Practice Address - Street 1:120 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-3115
Practice Address - Country:US
Practice Address - Phone:903-872-3772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX687821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical