Healthcare Provider Details

I. General information

NPI: 1649819160
Provider Name (Legal Business Name): ANNA WILKING PHD, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/01/2020
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 PARKSIDE AVE APT 14
BROOKLYN NY
11226-1188
US

IV. Provider business mailing address

145 E 125TH ST FL 4
NEW YORK NY
10035-1714
US

V. Phone/Fax

Practice location:
  • Phone: 646-647-5924
  • Fax:
Mailing address:
  • Phone: 718-277-0386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100115
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: