Big Heart Journey Inc

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

BIG HEART JOURNEY INC

Doing business as

Wyld Transformation

Practice address

115 E 5TH St
Mountain Home, AR 72653-3811

Phone

(928) 607-5531

NPI assigned

Nov 6, 2023

Organization subpart

No

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

Authorized official

Name

Holly Skinner

Title

Credentialing

Phone

(501) 454-1664

Specialties & licenses 1

Addresses

Other names 1

• Wyld Transformation Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

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

• Gemma Hollmann, LPC

  • Professional Counselor
  • Mountain Home, AR
  • NPI 1740868447
  Medicare reassignment NPD

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1992578363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1483 WEBBER RD",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726536938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E 5TH ST",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533811",
            "telephone_number": "928-607-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG HEART JOURNEY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-06",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "501-454-1664"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wyld Transformation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason Allen Bentley, PHARMD
• Allen Benz, ANP
• Tammy J Berke, PHD
• Sabrina Berry, PARAPROFESSIONAL
• Lacie Bettencourt, PTA
• Jaclyn Billins, LCSW
• Michelle R Bird, CST/CFA
• Billy Gene Bisswanger, MD
• John P Black, MD
• Beth Ann Blackburn, MHPP

• Professional Counselor in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.