Provider Demographics
NPI:1518467265
Name:WILKINS, KENYA J (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KENYA
Middle Name:J
Last Name:WILKINS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MISS
Other - First Name:KENYA
Other - Middle Name:J
Other - Last Name:LOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW,LCSW
Mailing Address - Street 1:8604 CLIFF CAMERON DR STE 152
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-8526
Mailing Address - Country:US
Mailing Address - Phone:704-510-5600
Mailing Address - Fax:
Practice Address - Street 1:8604 CLIFF CAMERON DR STE 152
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-8526
Practice Address - Country:US
Practice Address - Phone:704-510-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0115971041C0700X
NCC0128901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical