LOGAN OLIVIA WILDER-INGRAM
NPI 1760908263
Counselor - Professional in Hamilton, OH

Q: What is Logan Wilder-ingram's NPI number?

The NPI number for Logan Wilder-ingram is 1760908263. It was assigned to this individual provider in the NPPES registry on August 16, 2017.

Q: What is Logan Wilder-ingram's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Active since August 16, 2017PECOS EnrolledAccepts Medicare Assignment

1910 FAIRGROVE AVE, HAMILTON, OH 45011(513) 494-4679 Get Directions Write a Review

NPPES record last updated: October 20, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 5, 2024, Aug 16, 2023, May 23, 2023 and 3 more (6 updates tracked since 2017).

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About Logan Olivia Wilder-ingram NPPES

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

LOGAN OLIVIA WILDER-INGRAM (NPI 1760908263) is an individual professional provider in Hamilton, Ohio, licensed in Ohio (E.2505581) and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1760908263

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameLOGAN OLIVIA WILDER-INGRAM

Location Address1910 FAIRGROVE AVEHamilton, OH 45011-1930

Mailing Address1910 Fairgrove AveHamilton, OH 45011-1930 · (513) 494-4679

Phone(513) 494-4679

Sole ProprietorYes

Medical School CMSOtherGraduated 2022

Enumeration DateAugust 16, 2017

Last NPPES UpdateOctober 20, 20256 updates tracked since enumeration

NPPES CertifiedOctober 20, 2025

✔ NPI 1760908263 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in OH · E.2505581

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License LCDCIII.161933 (OH), CDCA.167891 (OH), LICDC.162260 (OH), CDCA.164220 (OH)

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License C.2204204 (OH)

1910 FAIRGROVE AVE, Hamilton, OH 45011

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Other Identifiers 1

Medicaid0443789OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

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

Logan Olivia Wilder-ingram 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 ID2365936812

PECOS Enrollment IDI20251211001315

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.

GERALD GRAHAM

Case Manager/Care Coordinator