Wildwood Mental Health LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

WILDWOOD MENTAL HEALTH LLC

Practice address

1833 W US Highway 2 Ste B
Grand Rapids, MN 55744-4733

Phone

(218) 392-5904

NPI assigned

Oct 14, 2022

Organization subpart

No

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

Authorized official

Name

Tabbatha Litchke HerdmanNPI 1518453554

Title

LPCC

Phone

(218) 301-6278

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

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

• Tabbatha Jo Litchke Herdman, MS ED, LPCC

  • Professional Counselor
  • Grand Rapids, MN
  • NPI 1518453554
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775347200000",
    "number": "1811613599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 124",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557440050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 W US HIGHWAY 2 STE B",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557444733",
            "telephone_number": "218-392-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDWOOD MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-14",
        "last_updated": "2026-04-05",
        "certification_date": "2026-04-05",
        "status": "A",
        "authorized_official_last_name": "LITCHKE HERDMAN",
        "authorized_official_first_name": "TABBATHA",
        "authorized_official_title_or_position": "LPCC",
        "authorized_official_telephone_number": "218-301-6278"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny Wettersten, MA, LP
• Gary Dean Wheelock, DC
• Chandra Lynn White, PMHNP
• Kaeley Therese Whiting Allen, MD
• Kelly Wier
• Jennifer Lynn Wilson, B.S., LADC
• Jessica Winkels-Hagerl, MS, LPCC
• Wise Minds by Rhea PLLC
• Janet Woehrle, RN, MS, CNS
• Andrew Joseph Wolak, PT, DPT

• Professional Counselor in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.