Wildly Authentic Counseling, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

WILDLY AUTHENTIC COUNSELING, LLC

Practice address

12443 San Jose Blvd Ste 202
Jacksonville, FL 32223-8648

Phone

(904) 337-9040

NPI assigned

Aug 13, 2021

Organization subpart

No

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

Authorized official

Name

Amy Kristine Schaet, LMHC, LPC

Title

Owner

Phone

(904) 885-8278

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Amy Kelley, LPC

  • Professional Counselor
  • Lake City, FL
  • NPI 1275870388
  NPD

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1053086793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735465",
            "telephone_number": "904-885-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12443 SAN JOSE BLVD STE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238648",
            "telephone_number": "904-337-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDLY AUTHENTIC COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-13",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "SCHAET",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "KRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-885-8278",
        "authorized_official_credential": "LMHC, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyson Gibson Wilder, PHARMD, BCPS
• Robert Edward Wilder Jr., M.DIV., M.ED.
• Carrie Wildes
• Wildflower Pediatric Therapy
• Wildflowers & Weeds
• Wiles & Associates 6970 PA
• Alexandra Wiles, MS CCC-SLP
• Wiley Retirement Home
• Amy L Wiley, M.S., CCC-SLP
• Bridgett Princess Wiley

• Professional Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Professional Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.