MEDICARE: WILD ROSE MENTAL HEALTH PLLC

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1851258784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILD ROSE MENTAL HEALTH PLLC

Provider Business Mailing Address
First Line	:	7761 N 55TH E
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83401-5530
Country	:	US
Telephone Number	:	986-294-0262
Fax Number	:	208-693-9024

Provider Business Practice Location Address
First Line	:	330 SHOUP AVE STE 313
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83402-3650
Country	:	US
Telephone Number	:	986-294-0262
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	JESSICA COLBERT
Credential	:	LCSW
Telephone Number	:	986-294-0262

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	05/15/2026

Similar Medicare Providers

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1972061059 — JESSICA JANELLE COLBERT LCSW
Practice Location Address:

330 SHOUP AVE STE 313
IDAHO FALLS, ID
83402-3650

Practice Phone: 986-294-0262
Practice Fax:

1235902610 — ASSURANCE FAMILY CARE LLC
Practice Location Address:

330 SHOUP AVE STE 204
IDAHO FALLS, ID
83402-3650

Practice Phone: 208-516-2041
Practice Fax:

1508695362 — DR. ASHLEY WASILEWSKI PSYD
Practice Location Address:

330 SHOUP AVE STE 206
IDAHO FALLS, ID
83402-3650

Practice Phone: 208-715-7551
Practice Fax:

1104687185 — JESS FROST LMT
Practice Location Address:

1743 PARK GARDEN RD
GREAT FALLS, MT
59404-3650

Practice Phone: 406-799-0357
Practice Fax: 406-780-3899

1639000425 — CELICA DIAZ
Practice Location Address:

855 N CAPITAL AVE STE 1
IDAHO FALLS, ID
83402-3405

Practice Phone: 208-552-0855
Practice Fax:

Directions to “WILD ROSE MENTAL HEALTH PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.