Provider Demographics
NPI:1770001430
Name:WILKINS, THOMAS MICHAEL (LCSW)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:MICHAEL
Last Name:WILKINS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:WILKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 471291
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80047-1291
Mailing Address - Country:US
Mailing Address - Phone:720-907-5966
Mailing Address - Fax:
Practice Address - Street 1:16104 E ALASKA PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-3710
Practice Address - Country:US
Practice Address - Phone:720-907-5966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-01
Last Update Date:2017-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW099248941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical