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General NPI Number Information
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NPI Number | 1861271611
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Entity Type | Individual
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Provider Name | MARY WILCOX LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 2800 W 21ST ST
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City | ERIE
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State | PA
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Zip | 16506-2980
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Country | US
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Telephone | 814-790-4003
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 W 21ST ST
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City | ERIE
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State | PA
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Zip | 16506-2980
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Country | US
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Telephone | 814-790-4003
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW026569
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW135375
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License Number State | PA
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