Kimberly Diane Wilder, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH14823 Issued in FL

Practice address

1114 Thomasville Rd Ste W
Tallahassee, FL 32303-6273

Phone

(850) 273-0199

Fax

(850) 792-2491

NPI assigned

Nov 17, 2014

Last updated

Nov 10, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Kimberly Diane Sanders(Christian) Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Trauma Healing Collective, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tallahassee, FL
  • NPI 1336880293
  NPD Authorized official
• Wilder Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tallahassee, FL
  • NPI 1861243065
  NPD Authorized official

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731196800000",
    "number": "1073919155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 THOMASVILLE RD STE W",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323036273",
            "telephone_number": "850-273-0199",
            "fax_number": "850-792-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 THOMASVILLE RD STE W",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323036273",
            "telephone_number": "850-273-0199",
            "fax_number": "850-792-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "KIMBERLY",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-17",
        "last_updated": "2024-11-10",
        "certification_date": "2024-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "13838",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH14823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SANDERS(CHRISTIAN)",
            "middle_name": "DIANE",
            "credential": "WILDER WELLNESS, LLC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Shyanna Noel Wilde
• Amy C Wildenstein, MS PT
• Wilder Wellness
• Aisha K Wilder, PHARMD
• Felicia Wilder
• Rhonda Davidson Wilder, PT
• Victoria Harlie Wilder
• Judith Husband Wiley, BCBA
• Ryan Wilhite
• Christopher Andrew Wilhoit, MD

• Mental Health Counselor in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.