Healthcare Provider Details

I. General information

NPI: 1659257830
Provider Name (Legal Business Name): STONE & WILDFLOWER COUNSELING & CONSULTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2729 PINE TRACE DR
MAUMEE OH
43537-1543
US

IV. Provider business mailing address

2729 PINE TRACE DR
MAUMEE OH
43537-1543
US

V. Phone/Fax

Practice location:
  • Phone: 419-573-5902
  • Fax:
Mailing address:
  • Phone: 419-573-5902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA KODJIKU
Title or Position: OWNER
Credential: LISW-S
Phone: 419-573-5902