Sammy Wilkerson, LPC/LADAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P1106045 Issued in AR

Practice address

706 S. Bochardt
Monticello, AR 71655-9663

Phone

(870) 723-7867

NPI assigned

Mar 27, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1376661157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 BURNETT LN",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716559274",
            "telephone_number": "870-723-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 S. BOCHARDT",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716559663",
            "telephone_number": "870-723-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "SAMMY",
        "name_prefix": "Mr.",
        "credential": "LPC/LADAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AR",
            "license": "0288L",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1106045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia P West
• Derek Lee White, FNP-C
• Lois White, QBHP
• Niketta White
• Samantha Wilkerson
• John Douglas Williams, AT
• Keely Shaye Williams
• Latisha M Williams
• Tylaria Williams
• William W Williams, DO

• Professional Counselor in Monticello, AR
• Providers in Monticello, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.