Healthcare Provider Details

I. General information

NPI: 1942080718
Provider Name (Legal Business Name): CATHERINE WILBANKS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2023
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 ALABAMA AVE NW
FORT PAYNE AL
35967-2641
US

IV. Provider business mailing address

709 ALABAMA AVE NW
FORT PAYNE AL
35967-2641
US

V. Phone/Fax

Practice location:
  • Phone: 256-273-7012
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: