Active NPI
Cathleen S Wilde, MA, LPCC
- Professional Counselor
- Albuquerque, NM
National Provider Identifier
1174843304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0070981
- Practice address
- 3321 Candelaria Rd NE
Albuquerque, NM 87107-1966 - Phone
- (505) 269-2429
- NPI assigned
- Jun 10, 2010
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0070981 | NM | Primary |
Addresses
Primary practice location
3321 Candelaria Rd NE
Albuquerque, NM 87107-1966
Mailing address
29 Taft Rd
Sandia Park, NM 87047-7907
Phone (505) 269-2429
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241031002157 | NM | Practitioner - Mental Health Counselor | 2466985213 | Practice locations: Albuquerque, NM |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0070981 | NM | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490572800000",
"number": "1174843304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 TAFT RD",
"city": "SANDIA PARK",
"state": "NM",
"postal_code": "870477907",
"telephone_number": "505-269-2429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3321 CANDELARIA RD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871071966",
"telephone_number": "505-269-2429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDE",
"first_name": "CATHLEEN",
"middle_name": "S",
"name_prefix": "Ms.",
"credential": "MA, LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-10",
"last_updated": "2017-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NM",
"license": "0070981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.