Provider Demographics
NPI:1629447487
Name:WILKINSON, JAMIE FRANCIS (LPCC)
Entity Type:Individual
Prefix:MR
First Name:JAMIE
Middle Name:FRANCIS
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7516 US HIGHWAY 42 APT 5
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1972
Mailing Address - Country:US
Mailing Address - Phone:859-816-8062
Mailing Address - Fax:859-203-0481
Practice Address - Street 1:7516 US HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1981
Practice Address - Country:US
Practice Address - Phone:859-816-8062
Practice Address - Fax:859-203-0481
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2019-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYLPCCCA00223149101YM0800X, 101YP2500X
KY246422101YP2500X, 101YM0800X
KY0331171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator