NPIMap

Organization Active NPI

Trauma Healing Collective, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tallahassee, FL
National Provider Identifier
1336880293
Registry record updated Nov 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
TRAUMA HEALING COLLECTIVE, LLC
Practice address
1114 Thomasville Rd Ste W
Tallahassee, FL 32303-6273
Phone
(850) 273-0199
Fax
(850) 792-2491
NPI assigned
Apr 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2024

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

Authorized official

Name
Mrs. Kimberly Diane WilderNPI 1073919155
Title
LMHC/Owner
Phone
(850) 273-0199

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

1114 Thomasville Rd Ste W
Tallahassee, FL 32303-6273

Mailing address

1114 Thomasville Rd Ste W
Tallahassee, FL 32303-6273
Phone (850) 273-0199

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731196800000",
    "number": "1336880293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 THOMASVILLE RD STE W",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323036273",
            "telephone_number": "850-273-0199",
            "fax_number": "850-792-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 THOMASVILLE RD STE W",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323036273",
            "telephone_number": "850-273-0199",
            "fax_number": "850-792-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAUMA HEALING COLLECTIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2024-11-10",
        "certification_date": "2024-11-10",
        "status": "A",
        "authorized_official_last_name": "WILDER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "LMHC/OWNER",
        "authorized_official_telephone_number": "850-273-0199",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2024; 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.