Provider Demographics
NPI:1689953721
Name:WILKINSON, ERIC THOMAS (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:THOMAS
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 OLD LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-1998
Mailing Address - Country:US
Mailing Address - Phone:859-687-7007
Mailing Address - Fax:859-687-7007
Practice Address - Street 1:118 OLD LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-1998
Practice Address - Country:US
Practice Address - Phone:859-687-7007
Practice Address - Fax:859-687-7007
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical