Provider Demographics
NPI:1598560781
Name:WILDFLOWER ONLINE WELLNESS
Entity type:Organization
Organization Name:WILDFLOWER ONLINE WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:KAITLYN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:205-461-1444
Mailing Address - Street 1:PO BOX 660037
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35266-0037
Mailing Address - Country:US
Mailing Address - Phone:205-461-1444
Mailing Address - Fax:
Practice Address - Street 1:3408 SANDNER CT APT C
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-5650
Practice Address - Country:US
Practice Address - Phone:205-356-9817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-13
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health