Provider Demographics
NPI:1245612209
Name:WILKINS, TREVOR (PHD, LPCC)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:
Last Name:WILKINS
Suffix:
Gender:M
Credentials:PHD, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 BEASLEY STREET #120
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509
Mailing Address - Country:US
Mailing Address - Phone:859-254-1035
Mailing Address - Fax:
Practice Address - Street 1:228 E REYNOLDS RD STE B6
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-1279
Practice Address - Country:US
Practice Address - Phone:800-464-1958
Practice Address - Fax:888-503-2470
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY174404101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional