Individual provider Active NPI

Alice Wilkerson, PH.D.

  • Counseling Psychologist
  • Roanoke, VA
National Provider Identifier
1356312987
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
0701000968 Issued in VA
Practice address
2762 Electric Rd
Suite C
Roanoke, VA 24018-3582
Phone
(540) 772-5140
Fax
(540) 772-5131
NPI assigned
Jan 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 0701000968 VA Primary
Family Psychologist 103TF0000X 0701000968 VA

Addresses

Primary practice location

2762 Electric Rd
Suite C
Roanoke, VA 24018-3582

Mailing address

2762 Electric Rd
Suite C
Roanoke, VA 24018-3582
Phone (540) 772-5140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241227001690 VA Practitioner - Mental Health Counselor 4385171685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological Health Roanoke PCGroup PAC ID 4981606076, 13 clinicians

Practice addresses (Care Compare)

2840 Electric Rd
Suite 200
Roanoke, VA 24018-3551
Phone (540) 777-7087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0701000968VAMDFamily Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Health Roanoke PC CurrentSince Dec 9, 2024 Accepting new patients
Lewis Gale Physicians LLC Past Accepting new patients
Lewis Gale Physicians LLC Past Accepting new patients

Locations

2840 Electric Rd
Ste 200
Roanoke, VA 24018
Phone (540) 772-5153

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1356312987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2762 ELECTRIC RD",
            "address_2": "SUITE C",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183582",
            "telephone_number": "540-772-5140",
            "fax_number": "540-772-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2762 ELECTRIC RD",
            "address_2": "SUITE C",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183582",
            "telephone_number": "540-772-5140",
            "fax_number": "540-772-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "ALICE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "VA",
            "license": "0701000968",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "VA",
            "license": "0701000968",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.