Wildflowers & Weeds

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WILDFLOWERS & WEEDS

Practice address

4110 Southpoint Blvd Ste 116
Jacksonville, FL 32216-0925

Phone

(904) 325-9155

NPI assigned

Jul 8, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Amanda Forrest, LCSWNPI 1346575057

Title

Owner

Phone

(904) 325-9155

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Forrest, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1346575057
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649721600000",
    "number": "1508437773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13245 ATLANTIC BLVD STE 4-243",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322257121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 SOUTHPOINT BLVD STE 116",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322160925",
            "telephone_number": "904-325-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDFLOWERS & WEEDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-08",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "FORREST",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-325-9155",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://wildflowers-and-weeds.clientsecure.me",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "web portal",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "text",
            "address_1": "4110 Southpoint Blvd Ste 116",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322160925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rebekah Leah Wildenberg
• Alyson Gibson Wilder, PHARMD, BCPS
• Robert Edward Wilder Jr., M.DIV., M.ED.
• Carrie Wildes
• Wildflower Pediatric Therapy
• Wildly Authentic Counseling, LLC
• Wiles & Associates 6970 PA
• Alexandra Wiles, MS CCC-SLP
• Wiley Retirement Home
• Amy L Wiley, M.S., CCC-SLP

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.