Wilder Wellness

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

WILDER WELLNESS

Practice address

1114 Thomasville Rd Ste W
Tallahassee, FL 32303-6273

Phone

(850) 273-0199

Fax

(850) 792-2491

NPI assigned

Mar 27, 2024

Organization subpart

No

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

Authorized official

Name

Miss Kimberly Diane Wilder, LMHCNPI 1073919155

Title

Founder

Phone

(850) 273-0199

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Kimberly Diane Wilder, LMHC

  • Mental Health Counselor
  • Tallahassee, FL
  • NPI 1073919155
  NPD Authorized official

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731196800000",
    "number": "1861243065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 THOMASVILLE RD STE W",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323036273",
            "telephone_number": "850-273-0199",
            "fax_number": "850-792-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 THOMASVILLE RD STE W",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323036273",
            "telephone_number": "850-273-0199",
            "fax_number": "850-792-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDER WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-11-10",
        "certification_date": "2024-11-10",
        "status": "A",
        "authorized_official_last_name": "WILDER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "850-273-0199",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chandra Yvette Wilcox, RPH
• Michele Renee Wilcox, APRN
• Carrington Kathleen Wilde
• Shyanna Noel Wilde
• Amy C Wildenstein, MS PT
• Aisha K Wilder, PHARMD
• Felicia Wilder
• Kimberly Diane Wilder, LMHC
• Rhonda Davidson Wilder, PT
• Victoria Harlie Wilder

• Mental Health Clinic/Center (Including Community Mental Health Center) in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2024; 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.