Corey Wilks, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1268 Issued in WV

Practice address

4602 Maccorkle Ave SE
Charleston, WV 25304-1848

Phone

(304) 205-7535

NPI assigned

Nov 23, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1962006882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6103 CASPER DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402582593",
            "telephone_number": "304-690-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041848",
            "telephone_number": "304-205-7535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKS",
        "first_name": "COREY",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "1268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "corey.wilks@cchswv.org",
            "affiliation": "Y",
            "endpointDescription": "work email",
            "affiliationName": "Cabin Creek Health Center, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4602 MacCorkle Ave SE",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253041848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kathy Wilkerson
• Tracy Lynn Wilkerson, DDS
• Sara Wilkins
• Brandon Wilkinson, DO
• Emily Wilkinson
• Ann Willard, MS,CCCA
• Elizabeth Willard
• Marvin Willard
• Andrea J Willett, OUTREACH COORDINATOR
• Austin Alexander Willett, PHARMD

• Clinical Psychologist in Charleston, WV
• Providers in Charleston, WV by specialty
• Clinical Psychologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.