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NPI Code Detail

MEDICARE: BILLIE NICOLE WILDER LPCC

MEDICARE:   BILLIE NICOLE WILDER  LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor174900KY
2101YM0800XMental Health Counselor174900KY
3101YP2500XProfessional Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2CS2028300325OTHERKYCARESOURCE

General Provider Information

NPI Number : 1356657571
Entity Type Code : Individual
Provider Name (Legal Business Name) : BILLIE NICOLE WILDER LPCC
Provider Business Mailing Address
First Line : 106 BELINDA BLVD
Second Line :
City : DANVILLE
State : KY
Zip : 40422-3217
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 106 BELINDA BLVD
Second Line :
City : DANVILLE
State : KY
Zip : 40422-3217
Country : US
Telephone Number : 866-755-4258
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2010
Last Update Date : 09/17/2025

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Directions to “ BILLIE NICOLE WILDER LPCC” Practice Location

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