Wild Pine Wellness LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

WILD PINE WELLNESS LLC

Practice address

131 NW Hawthorne Ave Ste 211
Bend, OR 97703-2958

Phone

(619) 890-8425

NPI assigned

Jan 25, 2021

Organization subpart

No

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

Authorized official

Name

Allison Faucher Sherman, LPCNPI 1851835540

Title

Licensed Professional Counselor

Phone

(541) 904-0403

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.

• Allison Faucher Sherman

  • Professional Counselor
  • Redmond, OR
  • NPI 1851835540
  NPD Authorized official

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1740870641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 NW HAWTHORNE AVE STE 211",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 NW HAWTHORNE AVE STE 211",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032958",
            "telephone_number": "619-890-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD PINE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "FAUCHER SHERMAN",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "541-904-0403",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea S Wiggins, OT
• Emily C Wiggins, ND
• Rodney Phillip Wigle, MD
• William B Wignall, MD
• Maria Wilczek, M.D.
• Wild Within Wellness LLC
• Wilder Wellness LLC
• Trisha J Wilder, PA-C
• Wildflower Behavioral Therapy
• Wildflower Natural Medicine

• Mental Health Clinic/Center (Including Community Mental Health Center) in Bend, OR
• Providers in Bend, OR by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.