Provider Demographics
NPI:1831072057
Name:WILD MIND COUNSELING
Entity type:Organization
Organization Name:WILD MIND COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-728-2066
Mailing Address - Street 1:600 N 36TH ST STE 426
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8827
Mailing Address - Country:US
Mailing Address - Phone:601-689-4892
Mailing Address - Fax:206-844-9197
Practice Address - Street 1:600 N 36TH ST STE 426
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8827
Practice Address - Country:US
Practice Address - Phone:601-689-4892
Practice Address - Fax:206-844-9197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-26
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty