Provider Demographics
NPI:1184757148
Name:WILSON, ADAM CHRISTOPHER (PHD, LPC)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:CHRISTOPHER
Last Name:WILSON
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 630833
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80163-0833
Mailing Address - Country:US
Mailing Address - Phone:720-258-6232
Mailing Address - Fax:
Practice Address - Street 1:6399 S SANTA FE DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2912
Practice Address - Country:US
Practice Address - Phone:720-258-6232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4678101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health