DR. SAMANTHA MARIE WILDEMAN (NPI# 1871862086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871862086 |
| Entity Type | Individual |
| Full Name | DR. SAMANTHA MARIE WILDEMAN |
| Credential | PSY.D. |
| Practice Address |
700 South Ave W Suite C Missoula MT 59801-8000 |
| Practice Telephone | 4063965326 |
| Practice Fax Number | 4065491494 |
| Mailing Telephone | 4063965326 |
| Mailing Fax Number | 4065491494 |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2011-12-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
413 | MT | Behavioral Health & Social Service Providers |
| Street Address |
700 SOUTH AVE W SUITE C |
| City | MISSOULA |
| State | MT |
| Zip Code | 59801-8000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073681144 | Jane Camerson Wells | Psychiatry & Neurology | 700 South Ave W, Suite B, Missoula, MT 59801-8000 | 2006-11-30 |
| 1134660525 | Healing Homes Counseling Services | Counselor | 700 South Ave W, Suite C, Missoula, MT 59801-8000 | 2017-03-17 |
| 1942603782 | Coral Beck | Social Worker | 700 South Ave W, Suite F, Missoula, MT 59801-8000 | 2014-10-08 |
| 1679980965 | 3 Rivers Eyecare LLC | Optometrist | 700 South Ave W, Ste G, Missoula, MT 59801-8000 | 2014-07-17 |
| 1558511808 | Kendra Lynn Campbell | Massage Therapist | 700 South Ave W, Suite A, Missoula, MT 59801-8000 | 2008-09-23 |
| 1912182072 | Libby Mcintyre, Lcsw, Acsw, Pllc | Social Worker | 700 South Ave W, Suite B, Missoula, MT 59801-8000 | 2008-01-07 |
| 1184810442 | Sandy Sheppard Od PC | Optometrist | 700 South Ave W, Ste. G, Missoula, MT 59801-8000 | 2007-09-20 |
| 1336362110 | Elizabeth Wolff Mcintyre | Social Worker | 700 South Ave W, Suite B, Missoula, MT 59801-8000 | 2007-04-10 |
| 1548310287 | Sandy Sheppard | Optometrist | 700 South Ave W, Ste. G, Missoula, MT 59801-8000 | 2007-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681010 | Time To Thrive Pllc | Social Worker | 1836 South Ave. West, Missoula, MT 59801 | 2020-08-26 |
| 1740815653 | Yuzo Fujiki | Specialist/Technologist | 210 N California St 104, Missoula, MT 59801 | 2020-03-11 |
| 1407346596 | Stepping Stones Counseling, Pllc | Counselor | 202 Brooks St Ste 300, Missoula, MT 59801 | 2018-05-14 |
| 1437668530 | Rejuve Care Clinic, Inc | Plastic Surgery | 715 Kensingten, Ste 1, Missoula, Missoula, MT 59801 | 2017-09-21 |
| 1619499555 | Beatrice Elise Powers | Specialist/Technologist | 410 B Stephens Ave, Missoula, MT 59801 | 2017-07-12 |
| 1770012197 | Hannah Lepiane | Massage Therapist | 1313 S. 4th W., Missoula, MT 59801 | 2017-06-08 |
| 1811420227 | Celeste Willis | Social Worker | 1055 W. Sussex, Missoula, MT 59801 | 2017-04-04 |
| 1073050498 | Rina Kasuga | Specialist/Technologist | 913 Rimini Ct, Missoula, MT 59801 | 2017-01-24 |
| 1043756919 | Heather Bartz | Specialist/Technologist | 831 Hastings Ave, Missoula, MT 59801 | 2017-01-16 |
| 1255874517 | Sarabeth Haddad | Social Worker | 1055 W Sussex Ave, Missoula, MT 59801 | 2016-11-18 |
| Find all providers in zip 59801 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164760237 | Bryan Neil Cochran | Psychologist | Sb143 Dept of Psychology, Missoula, MT 59812-0001 | 2013-01-24 |
| 1639373939 | M.j.h.h., Inc. | Psychologist | 445 S 5th St W, Missoula, MT 59801-2619 | 2007-06-12 |
| 1013110113 | Janet P. Wollersheim | Psychologist | 1900 Brooks St, Missoula, MT 59801-6644 | 2007-06-06 |
| 1861694119 | Ammons Psychological Services, Pllc | Psychologist | 2831 Fort Missoula Rd Ste 201, Physicians' Center #2, Missoula, MT 59804-7401 | 2007-05-31 |
| 1245357177 | Nadine M. Wisniewski | Psychologist | 27 Fort Missoula Rd, Ste B4, Missoula, MT 59804-7206 | 2007-03-24 |
| 1841324738 | Craig Harold Ravesloot | Psychologist | 101 E Broadway St Ste 310, Missoula, MT 59802-4510 | 2007-03-15 |
| 1629127063 | Christine Fiore | Psychologist | 1444 Mansfield Ave, Missoula, MT 59812-0001 | 2007-01-08 |
| 1083778351 | David Schuldberg | Psychologist | 1444 Mansfield, (cpc), Missoula, MT 59812-1584 | 2006-12-21 |
| 1609942069 | Danette M Wollersheim | Psychologist | 129 W Kent Ave, Ste I, Missoula, MT 59801-6730 | 2006-11-28 |
| 1790855443 | Cindy L Miller | Psychologist | 1805 Bancroft, Ste I, Missoula, MT 59801 | 2006-11-09 |
| Find all providers in MISSOULA | ||||
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| 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.