Wilder, Timothy M

Wilder, Timothy M is an individual health care provider with primary practice located at 4656 Brambleton Ave , Roanoke VA 24018-3437. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Wilder, Timothy M can be contacted via phone (540) 772-8043.

Contact Information

Primary practice address
4656 Brambleton Ave Roanoke VA 24018-3437
Phone: (540) 772-8043
Fax: (540) 772-8242
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701002845 Virginia

Profile Details

NPI number 1568446144
LBN Legal business name Wilder, Timothy M
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2005
Last updated Jul 13th, 2026 - about 3 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568446144 NPPES
Virginia Other 253575 ANTHEM BCBS
Virginia Other 272041 ANTHEM BCBS
Virginia Other 272041 ANTHEM BCBS
Virginia Other 465418 ANTHEM BCBS
Virginia Other 199752 ANTHEM BCBS
Virginia Other 7335124 ANTHEM BCBS
Virginia Other 2041553 ANTHEM BCBS

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