NPIMap

Organization Active NPI

Wildwood Integrative Depth Psychotherapy LLC

  • Clinical Social Worker
  • Sheffield Village, OH
National Provider Identifier
1417855834
Registry record updated Oct 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WILDWOOD INTEGRATIVE DEPTH PSYCHOTHERAPY LLC
Practice address
5425 Detroit Rd Ste 6
Sheffield Village, OH 44054-3031
Phone
(440) 327-1800
NPI assigned
Oct 27, 2026
Last updated
Oct 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2026

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

Authorized official

Name
Gabrielle N Molina, MSW, LSW
Title
Psychotherapist
Phone
(702) 557-4950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

5425 Detroit Rd Ste 6
Sheffield Village, OH 44054-3031

Mailing address

372 Angela LN
Avon Lake, OH 44012-1132
Phone (216) 202-4366

National Provider Directory

National Provider Directory

Locations

5425 Detroit Rd
Ste 6
Sheffield Village, OH 44054

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1793059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793059200000",
    "number": "1417855834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 ANGELA LN",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440121132",
            "telephone_number": "216-202-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 DETROIT RD STE 6",
            "city": "SHEFFIELD VILLAGE",
            "state": "OH",
            "postal_code": "440543031",
            "telephone_number": "440-327-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDWOOD INTEGRATIVE DEPTH PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-27",
        "last_updated": "2026-10-27",
        "certification_date": "2026-10-27",
        "status": "A",
        "authorized_official_last_name": "MOLINA",
        "authorized_official_first_name": "GABRIELLE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "702-557-4950",
        "authorized_official_credential": "MSW, LSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheffield Village, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2026; 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.