Kathleen Marie Wilde, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2015013670 Issued in MO

Practice address

7272 Wurzbach Rd Ste 601
San Antonio, TX 78240-4803

Phone

(210) 615-3483

NPI assigned

May 24, 2021

Sex

Female

Sole proprietor

Yes

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 MO

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

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nystrom Counseling Mo PCGroup PAC ID 6103264494, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Nystrom Counseling Mo, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • O Fallon, MO
  • NPI 1184401762
  Medicare reassignment Care Compare group NPD
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763

  MO

  Medicare reassignment NPD
• Preferred Family Healthcare, Inc

  • Community/Behavioral Health Agency
  • Kirksville, MO
  • NPI 1649474206
  NPD
• Preferred Family Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hannibal, MO
  • NPI 1306721709
  NPD

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1831764760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 GLENVIEW DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633047908",
            "telephone_number": "210-615-3483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7272 WURZBACH RD STE 601",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404803",
            "telephone_number": "210-615-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2015013670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wild Courage Counseling, PLLC
• Carlos Wild, CRNA
• Samantha Wild, APRN FNP-C
• Elida Marie Wildberger, RN, MSN, OCN
• Jessica Wilde, F.N.P
• Susan E Wilden, LISW
• Alyssa Jene Wilder, DO
• Gwendolen Wilder
• James L Wilder, MD
• Janna Wilder, M.D.

• Clinical Social Worker in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; 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.