Provider Demographics
NPI:1184936460
Name:WILKINSON, ROBERT TYLER (LPC, NCC, ACS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:TYLER
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:LPC, NCC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30079
Mailing Address - Country:US
Mailing Address - Phone:334-498-2289
Mailing Address - Fax:
Practice Address - Street 1:5180 ROSWELL RD SUITE 106
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1717
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional