Active NPI
Vicky Lynne Wilder, NCC
- Professional Counselor
- Spotsylvania, VA
National Provider Identifier
1023315710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 61066
- Practice address
- 8913 Blvd of the General
Spotsylvania, VA 22553 - Phone
- (540) 786-7227
- Fax
- (877) 771-3419
- NPI assigned
- Feb 16, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 61066 | VA | Primary |
| Dance Therapist | 225600000X | 466-1986 | VA |
Addresses
Primary practice location
8913 Blvd of the General
Spotsylvania, VA 22553
Mailing address
8913 Boulvard of the General
Spotsylvania, VA 22553
Phone (540) 786-7227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61066 | VA | MD | Professional Counselor |
| 466-1986 | VA | MD | Dance Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297814400000",
"number": "1023315710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8913 BOULVARD OF THE GENERAL",
"city": "SPOTSYLVANIA",
"state": "VA",
"postal_code": "22553",
"telephone_number": "540-786-7227",
"fax_number": "877-771-3419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8913 BLVD OF THE GENERAL",
"city": "SPOTSYLVANIA",
"state": "VA",
"postal_code": "22553",
"telephone_number": "540-786-7227",
"fax_number": "877-771-3419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDER",
"first_name": "VICKY",
"middle_name": "LYNNE",
"name_prefix": "Mrs.",
"credential": "NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-16",
"last_updated": "2011-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "61066",
"primary": true
},
{
"code": "225600000X",
"taxonomy_group": "",
"desc": "Dance Therapist",
"state": "VA",
"license": "466-1986",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spotsylvania, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.