Kristina Wilkerson, QMHA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178012552 Issued in IL

Practice address

14 Health Services Dr
C/O Family Service Agency of Dekalb County
Dekalb, IL 60115-9637

Phone

(815) 758-8616

Fax

(815) 758-8159

NPI assigned

Feb 10, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1396018024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 ASPEN CT",
            "address_2": "APT 7",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601156523",
            "telephone_number": "702-517-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 HEALTH SERVICES DR",
            "address_2": "C/O FAMILY SERVICE AGENCY OF DEKALB COUNTY",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159637",
            "telephone_number": "815-758-8616",
            "fax_number": "815-758-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "KRISTINA",
        "credential": "QMHA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-10",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "1602498500",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178012552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "1602498500",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDFPR",
            "identifier": "178012552",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Whitehead
• Victoria Whitehill
• Christina Wickerham
• Darrell Wiley, M.D.
• Kathleen C Wilkerson
• Ocean Wilkerson
• Rhyann Brianna Willey, LCSW
• Angelica Williams
• Ashanti Williams
• Carrie Lee Williams, MS ALMFT

• Professional Counselor in Dekalb, IL
• Providers in Dekalb, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.