Organization Active NPI

Wild Expanse Counseling PLLC

  • Adult Mental Health Clinic/Center
  • Salt Lake City, UT
National Provider Identifier
1245029792
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
WILD EXPANSE COUNSELING PLLC
Practice address
1518 S 1100 E Ste B
Salt Lake City, UT 84105-2579
Phone
(385) 355-4478
NPI assigned
May 1, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Violet FlorosNPI 1174266365
Title
Owner
Phone
(603) 828-2693

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

1518 S 1100 E Ste B
Salt Lake City, UT 84105-2579

Mailing address

1074 1/2 E Kensington Ave
Salt Lake City, UT 84105-2404
Phone (603) 828-2693

National Provider Directory

National Provider Directory

Locations

1518 S 1100 E
Ste B
Salt Lake City, UT 84105
Phone (385) 355-1799

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1245029792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1074 1/2 E KENSINGTON AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841052404",
            "telephone_number": "603-828-2693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 S 1100 E STE B",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841052579",
            "telephone_number": "385-355-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD EXPANSE COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "FLOROS",
        "authorized_official_first_name": "VIOLET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "603-828-2693"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; 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.