Gary N Wilkerson

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0718000262 Issued in VA

Legal business name

GARY N WILKERSON

Practice address

3217 Commander Shepard Blvd
Hampton, VA 23666

Phone

(757) 215-8039

NPI assigned

Feb 10, 2017

Last updated

Feb 10, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gary N Wilkerson, LSATPNPI 1174292783

Title

Counselor

Phone

(267) 258-3894

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gary N Wilkerson, M.ED

  • Addiction (Substance Use Disorder) Counselor
  • Onancock, VA
  • NPI 1174292783
  Authorized official Same address or phone

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486684800000",
    "number": "1659819548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 494",
            "city": "ONANCOCK",
            "state": "VA",
            "postal_code": "234170494",
            "telephone_number": "267-258-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 COMMANDER SHEPARD BLVD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "23666",
            "telephone_number": "757-215-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY N WILKERSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-10",
        "last_updated": "2017-02-10",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "267-258-3894",
        "authorized_official_credential": "LSATP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "DE",
            "license": "0000066",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "0718000262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Hampton, VA
• Providers in Hampton, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.