HOLLY WILDER
NPI 1164973244
Counselor in Seattle, WA

Q: What is Holly Wilder's NPI number?

The NPI number for Holly Wilder is 1164973244. It was assigned to this individual provider in the NPPES registry on October 24, 2016.

Q: What is Holly Wilder's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Holly Wilder was last updated on March 29, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 24, 2016PECOS EnrolledAccepts Medicare Assignment

11000 LAKE CITY WAY NE, SEATTLE, WA 98125(206) 545-2320(206) 634-3596 Get Directions Write a Review

NPPES record last updated: March 29, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Holly Wilder NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HOLLY WILDER (NPI 1164973244) is an individual counselor in Seattle, Washington, licensed in Washington (MC60871044) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1164973244

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameHOLLY WILDER

Location Address11000 LAKE CITY WAY NESeattle, WA 98125

Mailing Address11000 Lake City Way NeSeattle, WA 98125-6748 · (206) 545-2320 · Fax (206) 634-3596

Phone(206) 545-2320

Fax(206) 634-3596

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateOctober 24, 2016

Last NPPES UpdateMarch 29, 2019

✔ NPI 1164973244 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in WA · MC60871044

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License MC60871044 (WA)

11000 LAKE CITY WAY NE, Seattle, WA 98125

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Holly Wilder is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062864705

PECOS Enrollment IDI20240118002664

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARK DANIELS

Counselor