| Mindy Wilkerson, Lcsw, Pllc | |
|
19 E Mountain St Fayetteville AR 72701-6067 | |
| (479) 222-1671 | |
| Not Available |
| Full Name | Mindy Wilkerson, Lcsw, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 19 E Mountain St, Fayetteville, Arkansas |
| Authorized Official Name and Position | Mindy Wilkerson (MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 3149224558 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindy Wilkerson, Lcsw, Pllc 22578 Oakview Rd Siloam Springs AR 72761-8246 Ph: (314) 922-4558 | Mindy Wilkerson, Lcsw, Pllc 19 E Mountain St Fayetteville AR 72701-6067 Ph: (479) 222-1671 |
| NPI Number | 1952903973 |
|---|---|
| Provider Enumeration Date | 11/13/2020 |
| Last Update Date | 11/13/2020 |
| Certification Date | 11/13/2020 |
| Medicare PECOS PAC ID | 2163875725 |
|---|---|
| Medicare Enrollment ID | O20240130003280 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952903973 | NPI | - | NPPES |
| 1396283875 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mindy Anne Wilkerson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396283875 PECOS PAC ID: 3072966639 Enrollment ID: I20240131001288 |
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