Provider Demographics
NPI:1396104881
Name:WILKIE, JOSEPH JAMES
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JAMES
Last Name:WILKIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16395 W 54TH AVE
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-1124
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1366 TAYLOR TOWN RD
Practice Address - Street 2:
Practice Address - City:WHITE BLUFF
Practice Address - State:TN
Practice Address - Zip Code:37187-4025
Practice Address - Country:US
Practice Address - Phone:720-988-9764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-12
Last Update Date:2025-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
COLPC.0017291101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor