Wild Oak Therapeutic Farm, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

WILD OAK THERAPEUTIC FARM, LLC

Practice address

29691 SW Riverwood Dr
West Linn, OR 97068-9440

Phone

(503) 880-2676

NPI assigned

Jan 3, 2025

Organization subpart

No

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

Authorized official

Name

Nicole Byers, LPCNPI 1982057725

Title

Owner

Phone

(503) 880-2676

Specialties & licenses 1

Addresses

Practitioners 1

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

• Nicole Byers, LPC

  • Mental Health Counselor
  • Portland, OR
  • NPI 1982057725
  NPD Authorized official

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

{
    "created_epoch": "1735862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1750190781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29691 SW RIVERWOOD DR",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970689440",
            "telephone_number": "503-880-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29691 SW RIVERWOOD DR",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970689440",
            "telephone_number": "503-880-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD OAK THERAPEUTIC FARM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-03",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "BYERS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-880-2676",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Reid Westover, DMD
• Trina F White, LMT
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• Sarah Jo Wickstrom, LAC
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• Mental Health Counselor in West Linn, OR
• Providers in West Linn, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.