WILLOW NICHOLE WILDE LCSW
NPI 1205616018
Social Worker - Clinical in Springfield, OR
About Willow Nichole Wilde Lcsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WILLOW NICHOLE WILDE LCSW (NPI 1205616018) is an individual clinical provider in Springfield, Oregon, licensed in Oregon (L17959) and active in the NPI registry since October 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Willow Nichole Wilde Lcsw 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.
Medicare Billing Reassignment
Medicare enrollment records show Willow Wilde reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Mountlake Terrace, WA 98043
- Reassigned Medicare billing, Oregon enrollment
- 234 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97478 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Willow Wilde's NPI number?
The NPI number for Willow Wilde is 1205616018. It was assigned to this individual provider in the NPPES registry on October 2, 2023.
Where is Willow Wilde located?
Willow Wilde practices at 1238 S 58th St, Springfield, OR 97478. The listed phone number is (541) 698-1805.
What is Willow Wilde's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Willow Wilde enrolled in Medicare?
Yes. Willow Wilde is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Willow Wilde's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Willow Wilde reassigns Medicare benefits to Mindful Therapy Group PC (Mountlake Terrace, WA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Willow Wilde's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Willow Wilde accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Willow Wilde as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Willow Wilde was last updated on April 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Willow Nichole Wilde, LCSW · NPI 1205616018
Clinical provider in Springfield, Oregon. Individual provider, active in the CMS NPPES registry since October 2, 2023.
## Identity
- **NPI:** 1205616018 (Entity type: Individual)
- **Enumerated:** October 2, 2023
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** L17959 (Oregon)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1238 S 58TH ST, Springfield, OR 97478-5474
- **Phone:** (541) 698-1805
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Mindful Therapy Group PC (NPI 1316238678, Mountlake Terrace, WA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** April 30, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1205616018) · Data from the CMS NPPES public registry.