Lori Wilder LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401014275 Issued in MI

Legal business name

LORI WILDER LLC

Practice address

41 Washington Ave Ste 384
Grand Haven, MI 49417-3311

Phone

(616) 402-4262

Fax

(616) 984-4603

NPI assigned

Oct 12, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Lori Wilder, LPC

Title

Owner

Phone

(616) 402-4262

Specialties & licenses 1

Addresses

Other names 1

• Wilder Counseling Services Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476230400000",
    "number": "1003366238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 WASHINGTON AVE STE 384",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494173311",
            "telephone_number": "616-402-4262",
            "fax_number": "616-984-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 WASHINGTON AVE STE 384",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494173311",
            "telephone_number": "616-402-4262",
            "fax_number": "616-984-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORI WILDER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A",
        "authorized_official_last_name": "WILDER",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-402-4262",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401014275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilder Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Linda Youmans, LPC
• Gregory Scott Ling, D.C.
• Robin M Linton-Fisher, PT
• Rebecca Ann Little
• Camelia Lonsway
• Love Inc of the Tri-Cities
• Gerald M Lunsford, CO
• Monica Ann Lyons, FNP
• Hillari Madison, MA, TLLP
• Michael James Major

• Professional Counselor in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.