Carrie Wildes

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2392 Edgewood Ave N
Jacksonville, FL 32254-1725

Phone

(904) 781-7797

NPI assigned

Aug 11, 2017

Last updated

Aug 11, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502409600000",
    "number": "1851816805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2807 GIBSON POST RD",
            "city": "FOLKSTON",
            "state": "GA",
            "postal_code": "315377127",
            "telephone_number": "912-276-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2392 EDGEWOOD AVE N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322541725",
            "telephone_number": "904-781-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDES",
        "first_name": "CARRIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-11",
        "last_updated": "2017-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Edward Wildasin, CRNA
• Nicholas Emil Wilde, MD
• Rebekah Leah Wildenberg
• Alyson Gibson Wilder, PHARMD, BCPS
• Robert Edward Wilder Jr., M.DIV., M.ED.
• Wildflower Pediatric Therapy
• Wildflowers & Weeds
• Wildly Authentic Counseling, LLC
• Wiles & Associates 6970 PA
• Alexandra Wiles, MS CCC-SLP

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2017; 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.