Individual provider Active NPI

Stephanie Gidley Wilds, MS, LPC, NCC

  • Mental Health Counselor
  • Gulf Shores, AL
National Provider Identifier
1992536908
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC05325 Issued in AL
Practice address
2200 W 2ND St Apt A203
Gulf Shores, AL 36542-3639
Phone
(251) 200-3050
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC05325 AL Primary

Addresses

Primary practice location

2200 W 2ND St Apt A203
Gulf Shores, AL 36542-3639

Mailing address

PO Box 6785
Gulf Shores, AL 36547-6785
Phone (251) 200-3050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20241126002096 AL Practitioner - Mental Health Counselor 3678008737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Altapointe Health Systems IncGroup PAC ID 1052224052, 97 clinicians

Practice addresses (Care Compare)

1015 Montlimar Dr
Mobile, AL 36609-1713
Phone (251) 450-2211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LPC05325ALMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Altapointe Health Systems, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Altapointe Health Systems, Inc. CurrentSince Sep 1, 2024 Accepting new patients

Locations

5750A Southland Dr
Mobile, AL 36693
Phone (251) 450-5901

1015 Montlimar Dr
Mobile, AL 36609
Phone (251) 450-2250

2400 Gordon Smith Dr
Mobile, AL 36617
Phone (251) 305-4660

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1992536908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6785",
            "city": "GULF SHORES",
            "state": "AL",
            "postal_code": "365476785",
            "telephone_number": "251-200-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W 2ND ST APT A203",
            "city": "GULF SHORES",
            "state": "AL",
            "postal_code": "365423639",
            "telephone_number": "251-200-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDS",
        "first_name": "STEPHANIE",
        "middle_name": "GIDLEY",
        "credential": "MS, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "LPC05325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Shores, AL

Sources for this page

Verify at the official NPI Registry.