Individual
MR. CHARLES TIMOTHY WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C., LMFT
Contact information
Practice address
2520 LINE AVE, SHREVEPORT, LA 71104-3022
(318) 221-9300
Mailing address
PO BOX 178, ELYSIAN FIELDS, TX 75642-0178
(318) 221-9300
(318) 212-5206
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1571
LA
106H00000X
Marriage & Family Therapist
Primary
89
LA
Other
Enumeration date
04/10/2007
Last updated
09/11/2025
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