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JACK WILDWOOD PHD
NPI 1205317906
Counselor - Mental Health in Morrisville, VT

Active since August 22, 2018
133 GALLERY LN, MORRISVILLE, VT 05661(802) 505-9044 Get Directions Write a Review

NPPES record last updated: December 17, 2025. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Dec 17, 2025, Aug 22, 2018 (2 updates tracked since 2018).

About Jack Wildwood Phd NPPES

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

JACK WILDWOOD PHD (NPI 1205317906) is an individual mental health provider in Morrisville, Vermont, licensed in Vermont (097.0135245) and active in the NPI registry since August 2018.

NPPES Registry Identity

NPI1205317906
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJACK WILDWOODCredential: PHD
Location Address133 GALLERY LNMorrisville, VT 05661-9057
Mailing AddressPo Box 287Hyde Park, VT 05655-0287
Phone(802) 505-9044
Sole ProprietorYes
Enumeration DateAugust 22, 2018
Last NPPES UpdateDecember 17, 20252 updates tracked since enumeration
NPPES CertifiedDecember 17, 2025
✔ NPI 1205317906 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in VT · 097.0135245
133 GALLERY LN, Morrisville, VT 05661
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Wildwood's NPI number?

The NPI number for Jack Wildwood is 1205317906. It was assigned to this individual provider in the NPPES registry on August 22, 2018.

Where is Jack Wildwood located?

Jack Wildwood practices at 133 Gallery Ln, Morrisville, VT 05661. The listed phone number is (802) 505-9044.

What is Jack Wildwood's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Jack Wildwood was last updated on December 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.