Healthcare Provider Details

I. General information

NPI: 1972154300
Provider Name (Legal Business Name): AMANDA WILKES LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2019
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10407 ASKEW AVE
KANSAS CITY MO
64137-1516
US

IV. Provider business mailing address

10407 ASKEW AVE
KANSAS CITY MO
64137-1516
US

V. Phone/Fax

Practice location:
  • Phone: 816-200-1620
  • Fax:
Mailing address:
  • Phone: 816-665-7725
  • Fax: 816-817-1619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number03557
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2019033341
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: