Healthcare Provider Details

I. General information

NPI: 1497637433
Provider Name (Legal Business Name): WILDCARD COLLECTIVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W3553 TWIN LN
REDGRANITE WI
54970-7069
US

IV. Provider business mailing address

W3553 TWIN LN
REDGRANITE WI
54970-7069
US

V. Phone/Fax

Practice location:
  • Phone: 303-915-2680
  • Fax:
Mailing address:
  • Phone: 303-915-2680
  • 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 Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: KATIE LYNN SCHMIDT
Title or Position: OWNER
Credential: MA, LPC, CSW
Phone: 303-915-2680