Cedric Wilson, Lpc, LLC

NPI #1013502137 in Roanoke, Virginia

Provider Information

NPI Number: 1013502137
Entity Type: Organization
Organization Name: Cedric Wilson, Lpc, LLC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Mar 2, 2021
Last Updated: Mar 2, 2021

Practice Location

Address: 3048 BRAMBLETON AVE SW
City: Roanoke
State: Virginia
ZIP Code: 24015-4404
Phone: (540) 339-7674

Authorized Official

Name: CEDRIC WILSON, LPC
Title: CEO & THERAPIST
Phone: (540) 339-7674

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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