Wildflower Wellness, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

WILDFLOWER WELLNESS, LLC

Practice address

200 S Main St Ste P3
Pocatello, ID 83204-3261

Phone

(208) 251-6789

NPI assigned

Feb 26, 2024

Last updated

Feb 26, 2024By 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

Misity D Olsen, LPC

Title

Owner

Phone

(208) 251-6789

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.

• Brandi Michelle Merrill, LCSW

  • Clinical Social Worker
  • Pocatello, ID
  • NPI 1407053812
  NPD

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1700642840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MAIN ST STE P3",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832043261",
            "telephone_number": "208-251-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S MAIN ST STE P3",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832043261",
            "telephone_number": "208-251-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDFLOWER WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "OLSEN",
        "authorized_official_first_name": "MISITY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-251-6789",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter Jordan Wickham, DPT
• Chloe Wilbur
• Ann Wilcox, FNP
• Bonnie M. Wilcox, LSW
• Brandon D Wilde, D.P.M.
• Emily Wiley
• Whitney Elaine Wilkins, PA-S
• Willard House Inc
• Ashlyn Alexis Willard
• Janene A Willer, M.A., CCC-SLP

• Mental Health Counselor in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.