Provider Demographics
NPI:1316340334
Name:WILKINSON, SHAINA DAWN (MSW, LMSW,LCSW)
Entity type:Individual
Prefix:MS
First Name:SHAINA
Middle Name:DAWN
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:MSW, LMSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ROOSEVELT AVE STE OFFICE2
Mailing Address - Street 2:
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-2809
Mailing Address - Country:US
Mailing Address - Phone:860-245-9764
Mailing Address - Fax:
Practice Address - Street 1:12 ROOSEVELT AVE STE OFFICE2
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-2809
Practice Address - Country:US
Practice Address - Phone:860-245-9764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-04
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT156991041C0700X
CT66631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical