Provider Demographics
NPI:1235169749
Name:WILKINS, DAN F (PHD LPC LMFT)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:F
Last Name:WILKINS
Suffix:
Gender:M
Credentials:PHD LPC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 TENAHA ST
Mailing Address - Street 2:
Mailing Address - City:CENTER
Mailing Address - State:TX
Mailing Address - Zip Code:75935
Mailing Address - Country:US
Mailing Address - Phone:936-598-6413
Mailing Address - Fax:936-598-4499
Practice Address - Street 1:325 TENAHA ST
Practice Address - Street 2:
Practice Address - City:CENTER
Practice Address - State:TX
Practice Address - Zip Code:75935
Practice Address - Country:US
Practice Address - Phone:936-598-6413
Practice Address - Fax:936-598-4499
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1348106H00000X
TX02891101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83218LOtherBCBS
TX025646301Medicaid