Provider Demographics
NPI:1518067495
Name:WICKERS, FRANK C (EDD, LPC)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:C
Last Name:WICKERS
Suffix:
Gender:M
Credentials:EDD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HOLBROOK ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1758
Mailing Address - Country:US
Mailing Address - Phone:434-791-2059
Mailing Address - Fax:434-791-2835
Practice Address - Street 1:108 HOLBROOK ST
Practice Address - Street 2:SUITE 203
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1758
Practice Address - Country:US
Practice Address - Phone:434-791-2059
Practice Address - Fax:434-791-2835
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000094101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health