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General NPI Number Information
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NPI Number | 1801556972
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Entity Type | Individual
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Provider Name | ASHLEY WILKE LPC, CADC
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Gender | Female
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Dates
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Enumeration Date | 12/30/2021
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Last Update Date | 12/30/2021
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Provider Practice Location Address
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Address Line | 11925 S HARLEM AVE
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1138
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Country | US
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Telephone | 708-608-9065
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Fax |
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Provider Business Mailing Address
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Address Line | 6653 167TH ST
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City | TINLEY PARK
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State | IL
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Zip | 60477-2831
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 178015792
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License Number State | IL
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