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ELLICIA WILDER LPC-IT, SAC-IT
NPI 1861156473
Counselor - Mental Health in Milwaukee, WI

Active since October 29, 2021PECOS EnrolledAccepts Medicare Assignment
930 W HISTORIC MITCHELL ST, MILWAUKEE, WI 53204(414) 383-9526(414) 671-6606 Get Directions Write a Review

NPPES record last updated: November 1, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Ellicia Wilder Lpc-it, Sac-it NPPES

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

ELLICIA WILDER LPC-IT, SAC-IT (NPI 1861156473) is an individual mental health provider in Milwaukee, Wisconsin, licensed in Wisconsin (4482-226) and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1861156473
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameELLICIA WILDERCredential: LPC-IT, SAC-IT
Location Address930 W HISTORIC MITCHELL STMilwaukee, WI 53204-3533
Mailing Address930 W Historic Mitchell StMilwaukee, WI 53204-3533 · (414) 383-9526
Phone(414) 383-9526
Fax(414) 671-6606
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateOctober 29, 2021
Last NPPES UpdateNovember 1, 2021
NPPES CertifiedNovember 1, 2021
✔ NPI 1861156473 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in WI · 4482-226
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 18729-130 (WI)
930 W HISTORIC MITCHELL ST, Milwaukee, WI 53204
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Network Health and more.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

Ellicia Wilder Lpc-it, Sac-it 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 ID6406299924
PECOS Enrollment IDI20240212001792
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.

Medicare Billing Reassignment

Medicare enrollment records show Ellicia Wilder reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Gerald L. Ignace Indian Health Center, Inc.
Same address
Federally Qualified Health Center (FQHC)
930 W HISTORIC MITCHELL ST
Milwaukee, WI 53204
  • Reassigned Medicare billing, Wisconsin enrollment
  • 22 clinicians in this Medicare group
NPI 1023064086 (414) 383-9526

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

MRS. CLAUDIA H WEILAND RDH
Dental Hygienist
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204
Milwaukee County (414) 383-9526
ERIN ASHLEY CHRISTMAS NP
Nurse Practitioner (Psychiatric/Mental Health)
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204
Milwaukee County (414) 383-9526
GERALD L. IGNACE INDIAN HEALTH CENTER, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204
Milwaukee County (414) 383-9526
LYDIA BIEHR APNP
Nurse Practitioner (Family)
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204
Milwaukee County (414) 383-9526
PAUL GINKEL M.D.
Obstetrics & Gynecology
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204
Milwaukee County (414) 383-9526
SARAH LYN DEANER LPC
Counselor (Professional)
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204
Milwaukee County (414) 383-9526
DR. ANTHONY L MANNILA APNP FNP-C
Nurse Practitioner (Family)
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204
Milwaukee County (414) 316-5103
MRS. MARILYN ELIZABETH LEFAIVRE P.T.
Physical Therapist
930 W HISTORIC MITCHELL ST
MILWAUKEE, WI 53204
Milwaukee County (414) 383-9526

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 Ellicia Wilder's NPI number?

The NPI number for Ellicia Wilder is 1861156473. It was assigned to this individual provider in the NPPES registry on October 29, 2021.

Where is Ellicia Wilder located?

Ellicia Wilder practices at 930 W Historic Mitchell St, Milwaukee, WI 53204. The listed phone number is (414) 383-9526.

What is Ellicia Wilder's specialty?

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

Is Ellicia Wilder enrolled in Medicare?

Yes. Ellicia Wilder 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 Ellicia Wilder's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ellicia Wilder reassigns Medicare benefits to Gerald L. Ignace Indian Health Center, Inc. (Milwaukee, WI). 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 Ellicia Wilder's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ellicia Wilder accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Network Health, Quartz and UnitedHealthcare list Ellicia Wilder 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 Ellicia Wilder was last updated on November 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.