Provider Demographics
NPI:1801191010
Name:WILKERSON, MEGAN SARAH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:SARAH
Last Name:WILKERSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12011 GOVERNMENT CENTER PKWY
Mailing Address - Street 2:SUITE 836
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22035-1105
Mailing Address - Country:US
Mailing Address - Phone:703-324-7000
Mailing Address - Fax:
Practice Address - Street 1:8350 RICHMOND HWY
Practice Address - Street 2:SUITE 415
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309-2300
Practice Address - Country:US
Practice Address - Phone:703-704-6327
Practice Address - Fax:703-704-6687
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040075651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical