Provider Demographics
NPI:1588549380
Name:WILKIE, MARY B (MA, LPCC, NCC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:B
Last Name:WILKIE
Suffix:
Gender:F
Credentials:MA, LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1546 COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-1340
Mailing Address - Country:US
Mailing Address - Phone:303-618-3889
Mailing Address - Fax:
Practice Address - Street 1:5353 W DARTMOUTH AVE # 305
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80227-5515
Practice Address - Country:US
Practice Address - Phone:303-618-3889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0023634101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health