Provider Demographics
NPI:1801210554
Name:WILKES, BRITTNEY (LPC)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:WILKES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 W MAIN ST STE 2G
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2666
Mailing Address - Country:US
Mailing Address - Phone:203-872-5577
Mailing Address - Fax:844-847-7193
Practice Address - Street 1:969 W MAIN ST STE 2G
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2666
Practice Address - Country:US
Practice Address - Phone:203-872-5577
Practice Address - Fax:844-847-7193
Is Sole Proprietor?:No
Enumeration Date:2014-02-14
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003086101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008071418Medicaid