Jeremey Alan Wilder, LLPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

640109402 Issued in MI

Practice address

41 Washington Ave Ste 368
Grand Haven, MI 49417-1378

Phone

(616) 844-3387

NPI assigned

Jun 8, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Wilder Counseling Services LLC

  • Mental Health Counselor
  • Saint Johns, MI
  • NPI 1487333456
  NPD Authorized official

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1386211407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12585 CANTERBURY CT",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494178353",
            "telephone_number": "616-844-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 WASHINGTON AVE STE 368",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171378",
            "telephone_number": "616-844-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "JEREMEY",
        "middle_name": "ALAN",
        "credential": "LLPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "640109402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Uganski Westrate, OD
• Linda Louise White, NP
• Abbey Marie Wierda, MA, LPC, LLMFT
• Hilary Erin Wierenga, LMT
• Jeremyn Duane Wiersma, LPC
• Carol Ann Wilkening, CRNA
• Joel S. Wilkinson, LLMSW
• Emma Williams
• Isabella Milan Williams
• Kyle Williams, MSW

• Mental Health Counselor in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.