Provider Demographics
NPI:1891229712
Name:WILCOX, CHRISTOPHER (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:WILCOX
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8807 VILLA VIEW CIR 202
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821
Mailing Address - Country:US
Mailing Address - Phone:352-208-0284
Mailing Address - Fax:
Practice Address - Street 1:8807 VILLA VIEW CIR
Practice Address - Street 2:202
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-4112
Practice Address - Country:US
Practice Address - Phone:352-208-0284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW140001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical