Provider Demographics
NPI:1841919990
Name:WILKS COUNSELING LLC
Entity type:Organization
Organization Name:WILKS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABRAM
Authorized Official - Middle Name:DILLON
Authorized Official - Last Name:WILKS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:573-673-1183
Mailing Address - Street 1:3612 CHATHAM DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-5638
Mailing Address - Country:US
Mailing Address - Phone:573-673-1183
Mailing Address - Fax:
Practice Address - Street 1:3612 CHATHAM DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-5638
Practice Address - Country:US
Practice Address - Phone:573-673-1183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty