Provider Demographics
NPI:1700167293
Name:WILMARTH, JAMI (LPC)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:
Last Name:WILMARTH
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 1:7105 SW 34TH AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-3961
Mailing Address - Country:US
Mailing Address - Phone:806-236-0418
Mailing Address - Fax:
Practice Address - Street 1:7105 SW 34TH AVE
Practice Address - Street 2:SUITE G
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-3961
Practice Address - Country:US
Practice Address - Phone:806-236-0418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2011-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63083101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health