MEDICARE: MR. RONALD KENT WILKINS JR. M.S. ED.

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
1	101YM0800X	Mental Health Counselor	39000103A	IN
2	101YS0200X	School Counselor	750482	IN

General Provider Information

NPI Number	:	1336138056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RONALD KENT WILKINS JR. M.S. ED.

Provider Business Mailing Address
First Line	:	1712 CODY AVE
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-5214
Country	:	US
Telephone Number	:	260-424-5576
Fax Number	:

Provider Business Practice Location Address
First Line	:	1712 CODY AVE
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-5214
Country	:	US
Telephone Number	:	260-424-5576
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	09/11/2025

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