Provider Demographics
NPI:1801614243
Name:WILKINS, ROBERT (LGPC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:WILKINS
Suffix:
Gender:M
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 HALSEY RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3221
Mailing Address - Country:US
Mailing Address - Phone:719-271-1714
Mailing Address - Fax:
Practice Address - Street 1:404 HALSEY RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3221
Practice Address - Country:US
Practice Address - Phone:719-271-1714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP15687101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor