Provider Demographics
NPI:1861759714
Name:WILKES, SHARON K (LMSW)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:K
Last Name:WILKES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 E GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3231
Mailing Address - Country:US
Mailing Address - Phone:517-374-8066
Mailing Address - Fax:517-374-5912
Practice Address - Street 1:2121 E GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3231
Practice Address - Country:US
Practice Address - Phone:517-374-8066
Practice Address - Fax:517-374-5912
Is Sole Proprietor?:No
Enumeration Date:2012-04-17
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010792011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical