THAD WILDERSON & ASSOCIATES PA (NPI# 1073928701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073928701 |
| Entity Type | Organization |
| Organization Name | THAD WILDERSON & ASSOCIATES PA |
| Practice Address |
475 University Ave W Saint Paul MN 55103-1959 |
| Practice Telephone | 6512258997 |
| Mailing Telephone | 6512258997 |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2014-06-20 |
| Authorized Official Name | MS. RHONDA EAVES (OFFICE & FINANCE MANAGER) |
| Authorized Official Telephone | 6512258997 |
| Authorized Official Credential | N/A |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | LP0061 | MN | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649362237 | Thad Wilderson & Associates Pa | Psychologist | 475 University Ave W, Saint Paul, MN 55103-1959 | 2006-09-29 |
| 1306973698 | Thad Wilderson & Associates Pa | Psychologist | 475 University Ave W, Saint Paul, MN 55103-1959 | 2007-02-27 |
| Street Address |
475 UNIVERSITY AVE W |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55103-1959 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649362237 | Thad Wilderson & Associates Pa | Psychologist | 475 University Ave W, Saint Paul, MN 55103-1959 | 2006-09-29 |
| 1932606878 | Charlotte Dawn Johnson | Counselor | 475 University Ave W, Saint Paul, MN 55103-1959 | 2018-04-08 |
| 1083029722 | Thaddeus Wilderson | Psychologist | 475 University Ave W, Saint Paul, MN 55103-1959 | 2014-06-20 |
| 1871770479 | Hynan Chiropractic Clinic | Clinic/Center | 475 University Ave W, Saint Paul, MN 55103-1959 | 2008-01-25 |
| 1306973698 | Thad Wilderson & Associates Pa | Psychologist | 475 University Ave W, Saint Paul, MN 55103-1959 | 2007-02-27 |
| 1427137298 | Gregory J. Hynan | Chiropractor | 475 University Ave W, Saint Paul, MN 55103-1959 | 2006-11-03 |
| 1841379674 | John J Hynan | Chiropractor | 475 University Ave W, Saint Paul, MN 55103-1959 | 2006-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972148161 | Najma Group Home LLC | Home Health | 494 Aurora Ave, St Paul, MN 55103 | 2019-11-12 |
| 1164910121 | Linda's A Mother's Touch | Registered Nurse | 727 Front Ave Apt 606, St. Paul, MN 55103 | 2018-04-25 |
| 1215432380 | Olidia Transit Inc | Non-emergency Medical Transport (VAN) | 476 W Minnehaha Ave, Saint Paul, MN 55103 | 2018-03-29 |
| 1730579764 | Leah Angela Vibar | Chiropractor | 616 Rice Street Ste. B, Moua-lor Chiropractic & Acupuncture, P.a., St. Paul, MN 55103 | 2015-01-29 |
| 1629372479 | Korme Koji | Registered Nurse | 413 Central Avenue, St Paul, MN 55103 | 2011-01-07 |
| 1427360114 | Olydia Home Care Inc | Home Health | 476 West Minnehaha Ave, Saint Paul, MN 55103 | 2010-07-09 |
| 1699908277 | Kathleen Mae Borchert | Clinical Nurse Specialist | 559 Capitol Bloulevard, St. Paul, MN 55103 | 2009-08-28 |
| 1164690442 | Chong Pao Thao | Technician | 23 Empire Drive, Suite 123, St Paul, MN 55103 | 2008-02-20 |
| 1245366806 | Quality Plus Home Healthcare Services Inc | Home Health | 383 University Ave W. Upper, St Paul, MN 55103 | 2007-02-26 |
| 1023176286 | Amherst H. Wilder Foundation | Assisted Living Facility | 280 Ravoux St, Saint Paul, MN 55103 | 2006-12-04 |
| Find all providers in zip 55103 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619435401 | Aurora Behavioral Health | Community/Behavioral Health | 1821 University Ave W Ste 225, Saint Paul, MN 55104-2895 | 2019-03-11 |
| 1821583295 | Integrate Counseling Pllc | Community/Behavioral Health | 1145 Grand Ave Ste 203, Saint Paul, MN 55105-2629 | 2018-06-27 |
| 1891233565 | Cp Consulting & Research, LLC | Community/Behavioral Health | 2395 University Ave W Ste 200, Saint Paul, MN 55114-1511 | 2017-02-02 |
| 1821533779 | Minneosta Wellness Center LLC | Community/Behavioral Health | 808 Berry St Apt 192, Saint Paul, MN 55114-1082 | 2017-01-02 |
| 1164875670 | Integrated Health | Community/Behavioral Health | 1830 Selby Ave, Saint Paul, MN 55104-6024 | 2016-07-20 |
| 1992150080 | Minnesota Mental Health Center | Community/Behavioral Health | 990 Payne Ave, Saint Paul, MN 55130-3987 | 2016-04-26 |
| 1629437793 | Integrated Health | Community/Behavioral Health | 2030 Saint Clair Ave, Saint Paul, MN 55105-1650 | 2016-02-18 |
| 1679949044 | Elite Recovery LLC | Community/Behavioral Health | 1145 Grand Ave, #101, Saint Paul, MN 55105-2629 | 2015-08-19 |
| 1316321235 | Aide Bilingual Services | Community/Behavioral Health | 914 Fuller Ave, Saint Paul, MN 55104-4741 | 2015-07-10 |
| 1871993832 | Mikemarekcounseling | Community/Behavioral Health | 615 Pascal St N, Saint Paul, MN 55104-2443 | 2014-08-27 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55103 |
Please comment or provide details below to improve the information on THAD WILDERSON & ASSOCIATES PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.