Active NPI
Joan R Wildfield, M.A., L.M.H.C.
- Mental Health Counselor
- Bellingham, WA
National Provider Identifier
1053434027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH00004307
- Practice address
- 119 N Commercial St
Suite 1100
Bellingham, WA 98225-4446 - Phone
- (360) 714-0830
- Fax
- (360) 714-8170
- NPI assigned
- Apr 6, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH00004307 | WA | Primary |
Addresses
Primary practice location
119 N Commercial St
Suite 1100
Bellingham, WA 98225-4446
Mailing address
PO Box 2742
Bellingham, WA 98227-2742
Phone (360) 714-0830
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 129881100000 | Other | WA | PREMERA BLUE CROSS |
| 17227 | Other | WA | REGENCE BLUE SHIELD |
| 827230 | Other | WA | DDD |
| 8924300 | Other | WA | CRIME VICTIMS COMPENSATIO |
| LH00004307 | Other | WA | WASHINGTON STATE LICENSE |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH00004307 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joseph W Lenz PHD, PS | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Haiku, HI
- NPI 1457486789
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053434027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2742",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982272742",
"telephone_number": "360-714-0830",
"fax_number": "360-714-8170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 N COMMERCIAL ST",
"address_2": "SUITE 1100",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982254446",
"telephone_number": "360-714-0830",
"fax_number": "360-714-8170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDFIELD",
"first_name": "JOAN",
"middle_name": "R",
"credential": "M.A., L.M.H.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH00004307",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREMERA BLUE CROSS",
"identifier": "129881100000",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "17227",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DDD",
"identifier": "827230",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS COMPENSATIO",
"identifier": "8924300",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE LICENSE",
"identifier": "LH00004307",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.