Healthcare Provider Details

I. General information

NPI: 1487588976
Provider Name (Legal Business Name): CLAUDIA WILKINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3220 68TH ST SE STE A
CALEDONIA MI
49316-7467
US

IV. Provider business mailing address

3220 68TH ST SE STE A
CALEDONIA MI
49316-7467
US

V. Phone/Fax

Practice location:
  • Phone: 616-217-3503
  • Fax:
Mailing address:
  • Phone: 616-217-3503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451025036
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: