Provider Demographics
NPI:1407183460
Name:WILKERBURY, LLC
Entity Type:Organization
Organization Name:WILKERBURY, LLC
Other - Org Name:PLAN B COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WILKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC
Authorized Official - Phone:828-850-7825
Mailing Address - Street 1:PO BOX 1280
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-1280
Mailing Address - Country:US
Mailing Address - Phone:828-850-7825
Mailing Address - Fax:828-355-9758
Practice Address - Street 1:890 W KING ST
Practice Address - Street 2:SUITE 108
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4690
Practice Address - Country:US
Practice Address - Phone:828-850-7825
Practice Address - Fax:828-355-9758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5250101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty