Provider Demographics
NPI:1730763814
Name:WILKERSON MCDONALD, ALEXIS L (LPC, LCMHC, PMH)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:L
Last Name:WILKERSON MCDONALD
Suffix:
Gender:F
Credentials:LPC, LCMHC, PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 E MAIN ST STE 310
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-3537
Mailing Address - Country:US
Mailing Address - Phone:610-680-0278
Mailing Address - Fax:
Practice Address - Street 1:1011 E MAIN ST STE 310
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-3537
Practice Address - Country:US
Practice Address - Phone:610-680-0278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701009914101YP2500X
NC19418101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional