Provider Demographics
NPI:1891712758
Name:WILKERSON'S CONSULTANTS, INC.
Entity Type:Organization
Organization Name:WILKERSON'S CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SERVICES DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KEMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-279-9468
Mailing Address - Street 1:4121 MEADOWDALE BLVD
Mailing Address - Street 2:SUITE C, BLDG. 1
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-5500
Mailing Address - Country:US
Mailing Address - Phone:804-279-9468
Mailing Address - Fax:804-279-9292
Practice Address - Street 1:4121 MEADOWDALE BLVD
Practice Address - Street 2:SUITE C, BLDG. 1
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23234-5500
Practice Address - Country:US
Practice Address - Phone:804-279-9468
Practice Address - Fax:804-279-9292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA463101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty