Wildflower Intuitive Center, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WILDFLOWER INTUITIVE CENTER, LLC

Practice address

4696 W Overland Rd Ste 276
Boise, ID 83705-2877

Phone

(208) 722-2200

Fax

(208) 912-0325

NPI assigned

Nov 12, 2019

Organization subpart

No

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

Authorized official

Name

Corie Sue Cook, LCSW, ACSWNPI 1487711305

Title

Clinical Director

Phone

(208) 722-2200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Corie Sue Cook, LMSW

  • Clinical Social Worker
  • Nampa, ID
  • NPI 1487711305
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573516800000",
    "number": "1235774407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4696 W OVERLAND RD STE 276",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837052877",
            "telephone_number": "208-722-2200",
            "fax_number": "208-912-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4696 W OVERLAND RD STE 276",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837052877",
            "telephone_number": "208-722-2200",
            "fax_number": "208-912-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDFLOWER INTUITIVE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-12",
        "last_updated": "2019-11-12",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "CORIE",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "208-722-2200",
        "authorized_official_credential": "LCSW, ACSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Wilburn
• Wild Heart Living
• Wild Milk PLLC (Wild Milk Co.)
• Wild Sage Counseling & Wellness PLLC
• Randy Wild, LCPC
• Wildflower OBGYN LLC
• Wildflower Telehealth Network Inc.
• Brandon J Wilding, M.D.
• Victoria Chlarson Wilding, MD
• Ann Marie Wildman, CTRS

• Clinical Social Worker in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.