Provider Demographics
NPI:1144100645
Name:WILDFLOWER WELLNESS COUNSELING
Entity type:Organization
Organization Name:WILDFLOWER WELLNESS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LPC
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASSIDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLIMORE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:602-695-6077
Mailing Address - Street 1:16960 W BELL RD STE 502
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-8937
Mailing Address - Country:US
Mailing Address - Phone:602-695-6077
Mailing Address - Fax:
Practice Address - Street 1:16960 W BELL RD STE 502
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-8937
Practice Address - Country:US
Practice Address - Phone:602-695-6077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty