Provider Demographics
NPI:1568679009
Name:WILKES, GAIL KRISTEN (MFT)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:KRISTEN
Last Name:WILKES
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3003
Mailing Address - Country:US
Mailing Address - Phone:717-394-5334
Mailing Address - Fax:717-394-8747
Practice Address - Street 1:321 N MARKET ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3003
Practice Address - Country:US
Practice Address - Phone:717-394-5334
Practice Address - Fax:717-394-8747
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007743280008Medicaid