Provider Demographics
NPI:1457348880
Name:WILKINSON, THOMAS B (LPCC, LICDC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:B
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:LPCC, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 GLENDALE MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-1231
Mailing Address - Country:US
Mailing Address - Phone:513-594-8373
Mailing Address - Fax:937-293-0650
Practice Address - Street 1:2670 WOODMAN CENTER CT
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45420-1477
Practice Address - Country:US
Practice Address - Phone:513-594-8373
Practice Address - Fax:937-293-0650
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0002163101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor