Holly Wilder

Primary specialty

CounselorTaxonomy code 101Y00000X

License

MC60871044 Issued in WA

Practice address

11000 Lake City Way NE
Seattle, WA 98125

Phone

(206) 545-2320

Fax

(206) 634-3596

NPI assigned

Oct 24, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SoundGroup PAC ID 1759282197, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Sound

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tukwila, WA
  • NPI 1780774950
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1164973244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11000 LAKE CITY WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981256748",
            "telephone_number": "206-545-2320",
            "fax_number": "206-634-3596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 LAKE CITY WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98125",
            "telephone_number": "206-545-2320",
            "fax_number": "206-634-3596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "HOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "MC60871044",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "MC60871044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wild Ember Counseling PLLC
• Wild Mind Counseling
• Hannah Wild-Neary
• Ellie Wilde, PHD
• Janelle Wilde, PHARMD
• Stacey Audrey Wildermuth
• Megan Wildhood
• Marian Wilding, MBA
• Rhys Evan Wilding
• Sydney Wile

• Counselor in Seattle, WA
• Providers in Seattle, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.