MEDICARE: AMY WILKINS L.C.P.C.

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	101YP2500X	Professional Counselor	180-003859	IL
2	101YP2500X	Professional Counselor	5403-125	WI

General Provider Information

NPI Number	:	1750625067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY WILKINS L.C.P.C.

Provider Business Mailing Address
First Line	:	1704 27TH ST
Second Line	:
City	:	MONROE
State	:	WI
Zip	:	53566-3636
Country	:	US
Telephone Number	:	815-262-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 11TH ST UNIT 1
Second Line	:
City	:	MONROE
State	:	WI
Zip	:	53566-1747
Country	:	US
Telephone Number	:	608-558-4677
Fax Number	:

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

Provider Enumeration Date	:	11/27/2012
Last Update Date	:	08/01/2022

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