Mark J Wilde, MA, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2333 Issued in MN

Practice address

525 Portland Ave
MC 963
Minneapolis, MN 55415-1533

Phone

(612) 596-1223

NPI assigned

May 28, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hennepin CountyGroup PAC ID 7911892849, 132 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hennepin County

  • Psychiatry Physician
  • Minneapolis, MN
  • NPI 1780790345
  Medicare reassignment Care Compare group NPD (past)
• Hennepin County

  • Community Health Clinic/Center
  • Minneapolis, MN
  • NPI 1154774925
  NPD
• Hennepin County

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1962147413
  NPD
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1801233192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE",
            "address_2": "MC 963",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-596-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE",
            "address_2": "MC 963",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-596-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4570 Churchill St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Shoreview",
            "state": "MN",
            "postal_code": "551262274",
            "country_code": "US",
            "telephone_number": "612-741-8286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDE",
        "first_name": "MARK",
        "middle_name": "J",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-28",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Ann Wilcox, M.D.
• Kristin Wilcox, MS, LPCC, LADC
• Erica Wilczek, PT, DPT
• Wild Hope Psychological Services LLC
• Anne Wild, LGSW
• Tomas John Wildenborg, LICSW
• Denise Wilder, M.EQ.
• Sanaa Tiairr Wilder
• Tira Marie Wiley-Walker
• Lyn Marie Wiley, COMS

• Marriage & Family Therapist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.