Healthcare Provider Details

I. General information

NPI: 1366399750
Provider Name (Legal Business Name): WISHING WELL COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5621 GOLF RIDGE DR APT A
SAINT LOUIS MO
63128-3343
US

IV. Provider business mailing address

5621 GOLF RIDGE DR APT A
SAINT LOUIS MO
63128-3343
US

V. Phone/Fax

Practice location:
  • Phone: 314-756-7512
  • Fax:
Mailing address:
  • Phone: 314-756-7512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ERIN ELIZABETH CHILSON
Title or Position: OWNER
Credential: M.ED, LPC
Phone: 314-756-7512