Into the Wild, Inc.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

INTO THE WILD, INC.

Practice address

5765 Shallowford Rd
Lewisville, NC 27023-9610

Phone

(336) 314-0051

NPI assigned

Nov 18, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Max Goelling, PHD

Title

Cfo

Phone

(336) 314-0051

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sonia Jean Downing-Hensel, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Winston Salem, NC
  • NPI 1245977982
  NPD

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1023775541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1291",
            "city": "KING",
            "state": "NC",
            "postal_code": "270211291",
            "telephone_number": "336-314-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5765 SHALLOWFORD RD",
            "city": "LEWISVILLE",
            "state": "NC",
            "postal_code": "270239610",
            "telephone_number": "336-314-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTO THE WILD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-18",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "GOELLING",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "336-314-0051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.intothewildhelps.org",
            "affiliation": "N",
            "endpointDescription": "Primary Website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Text",
            "address_1": "5765 Shallowford Rd",
            "city": "Lewisville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "270239610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicole D Herald, PHARMD
• Terry Douglas Hess, MD
• Vanessa Hess, RPH
• Briana Bralley Holt
• David Robb Holton, FNP
• Amy Elizabeth Field Ivester, M.A., CCC-SLP
• Caren Marie Jackson, MS/EDS, NCC, LPC
• Terry Lynn James
• Karen M Jarvis, MA, CCC-SLP
• Jason T. Moore, D.D.S. and Adam T. Dorsett, D.D.S., PA

• Addiction (Substance Use Disorder) Counselor in Lewisville, NC
• Providers in Lewisville, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.