Organization Active NPI

Wildheart Counseling, LLC

  • Social Worker
  • Fairbanks, AK
National Provider Identifier
1720957541
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
WILDHEART COUNSELING, LLC
Practice address
250 Cushman St Ste 5a
Fairbanks, AK 99701-4665
Phone
(907) 483-1333
NPI assigned
Oct 30, 2025
Last updated
Oct 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Authorized official

Name
Leslie Fails, LMSWNPI 1699500488
Title
Owner
Phone
(907) 483-1333

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
Social Worker 104100000X Primary

Addresses

Primary practice location

250 Cushman St Ste 5a
Fairbanks, AK 99701-4665

Mailing address

250 Cushman St Ste 5a
Fairbanks, AK 99701-4665
Phone (907) 483-1333

National Provider Directory

National Provider Directory

Locations

250 Cushman St
Ste 5A
Fairbanks, AK 99701
Phone (907) 456-2256

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": "1761782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761782400000",
    "number": "1720957541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CUSHMAN ST STE 5A",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014665",
            "telephone_number": "907-483-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CUSHMAN ST STE 5A",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014665",
            "telephone_number": "907-483-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDHEART COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-30",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A",
        "authorized_official_last_name": "FAILS",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-483-1333",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.