Nicole R Wildroudt, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-24135 Issued in AZ

Practice address

4104 Springmill Dr
Kokomo, IN 46902-5168

Phone

(937) 554-3667

NPI assigned

Apr 20, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

El Rio Santa Cruz Neighborhood Health Center, Inc.Group PAC ID 6305739244, 283 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• El Rio Santa Cruz Neighborhood Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1487602736
  Medicare reassignment Care Compare group NPD (past)
• El Rio Santa Cruz Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1174927727
  NPD (past)
• El Rio Santa Cruz Neighborhood Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1598457525
  NPD (past)
• El Rio Santa Cruz Neighborhood Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1750672929
  NPD (past)
• El Rio Santa Cruz Neighborhood Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1912440975
  NPD (past)
• Samaritan Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Dayton, OH
  • NPI 1235490939
  NPD (past)

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1235526096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4104 SPRINGMILL DR",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469025168",
            "telephone_number": "937-554-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4104 SPRINGMILL DR",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469025168",
            "telephone_number": "937-554-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDROUDT",
        "first_name": "NICOLE",
        "middle_name": "R",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "86000458A",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-24135",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2606445",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162012",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip L Whitfield, MD
• Megan Whittern, RBT
• Matthew Whybrew
• Michael R Wild, MD
• Paige Wild, RBT
• Paula Wilham, MD
• Donald Richard Wilka, LCSW
• Anna Wilkinson
• Abigail Williams
• Anna Catherine Williams, RD, LD

• Professional Counselor in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Professional Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.