Individual
KEVIN SEAN WILBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
98 U ST, SPRINGFIELD, OR 97477-2154
(470) 889-9360
Mailing address
98 U ST, SPRINGFIELD, OR 97477-2154
(470) 889-9360
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
003349
GA
101YP2500X
Professional Counselor
1396-4079-6004
UT
101YP2500X
Professional Counselor
7888
ID
101YP2500X
Professional Counselor
Primary
C8383
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10041237
—
GA
01
—
219822157
UNITED BEH. HEALTH
GA
05
—
236474735A
—
GA
01
—
23652616
AETNA
GA
01
—
280332000
MAGELLAN B.H.
GA
05
—
280332000
—
GA
01
—
506632
VALUE OPTIONS
GA
01
—
C410947618
CELTIC INSURANCE
GA
Enumeration date
11/08/2006
Last updated
10/02/2024
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