Provider Demographics
NPI:1548486772
Name:WILKINSON, KATHY (LPC, LADC)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:LPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7232 E 130TH ST S
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-2307
Mailing Address - Country:US
Mailing Address - Phone:918-951-3413
Mailing Address - Fax:
Practice Address - Street 1:4528 S SHERIDAN RD STE 101
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-1101
Practice Address - Country:US
Practice Address - Phone:918-398-7979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK468101YA0400X
OK1894101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health