NPIMap

Organization Active NPI

Wilder Counseling Services LLC

  • Mental Health Counselor
  • Saint Johns, MI
National Provider Identifier
1487333456
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WILDER COUNSELING SERVICES LLC
Practice address
1205 Glastonbury Dr
Saint Johns, MI 48879-3401
Phone
(616) 844-3387
NPI assigned
Jul 17, 2023
Last updated
Jul 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Authorized official

Name
Jeremey Alan Wilder, MANPI 1386211407
Title
Owner
Phone
(616) 844-3387

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
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

1205 Glastonbury Dr
Saint Johns, MI 48879-3401

Mailing address

1205 Glastonbury Dr
Saint Johns, MI 48879-3401
Phone (616) 844-3387

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689552000000",
    "number": "1487333456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 GLASTONBURY DR",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488793401",
            "telephone_number": "616-844-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 GLASTONBURY DR",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488793401",
            "telephone_number": "616-844-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDER COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-16",
        "status": "A",
        "authorized_official_last_name": "WILDER",
        "authorized_official_first_name": "JEREMEY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-844-3387",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.