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NPI Code Detail

MEDICARE: ELISHA WILKINSON

MEDICARE: ELISHA WILKINSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3104100000XSocial Worker

General Provider Information

NPI Number : 1255701918
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISHA WILKINSON
Provider Business Mailing Address
First Line : 2414 FERRAND ST
Second Line : SUITE 2
City : MONROE
State : LA
Zip : 71201-3249
Country : US
Telephone Number : 318-342-9979
Fax Number : 318-342-9980
Provider Business Practice Location Address
First Line : 645 HIGHWAY 80 E
Second Line :
City : MONROE
State : LA
Zip : 71203-8527
Country : US
Telephone Number : 318-343-8744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2015
Last Update Date : 07/26/2023

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Directions to “ ELISHA WILKINSON ” Practice Location

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