Wishing Well Therapy Services

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

WISHING WELL THERAPY SERVICES

Practice address

7760 Excelsior Rd Ste 104
Baxter, MN 56425-9768

Phone

(218) 851-1450

NPI assigned

Dec 22, 2023

Last updated

Dec 22, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miranda Joy Aulie, MSW, LICSWNPI 1487338117

Title

Owner, Therapist

Phone

(218) 851-1450

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Miranda Aulie, LICSW

  • Clinical Social Worker
  • Brainerd, MN
  • NPI 1487338117
  NPD Authorized official

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

{
    "created_epoch": "1703203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703203200000",
    "number": "1427827054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7760 EXCELSIOR RD STE 104",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564259768",
            "telephone_number": "218-851-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7760 EXCELSIOR RD STE 104",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564259768",
            "telephone_number": "218-851-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISHING WELL THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-22",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A",
        "authorized_official_last_name": "AULIE",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "218-851-1450",
        "authorized_official_credential": "MSW, LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David F Williams, MD
• Michelle Williams
• Erin Winkelman
• Jane L Winter, MD
• Heather Winters
• Mariah Gale Wittlief
• Justin Woitte, DPT
• Sydney Wold
• Bryn Yahn
• Timothy Carl Yezek

• Adult Mental Health Clinic/Center in Baxter, MN
• Providers in Baxter, MN by specialty
• Adult Mental Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.