MRS. JULIE ANNE DE WILDE (M.A., LPCC) – Professional Counselor, NPI 1083168314

MRS. JULIE ANNE DE WILDE (M.A., LPCC) is a healthcare provider. based in New brighton, Minnesota. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials M.A., LPCC. They hold a License No. CC01711 (MN). The NPI Number for MRS. JULIE ANNE DE WILDE (M.A., LPCC) is 1083168314

Main info

Female
27 Years Of Experience
Name
MRS. JULIE ANNE DE WILDE (M.A., LPCC)
NPI
1083168314
Phone
(651) 628-9566
Address
1900 SILVER LAKE RD NW
Enumeration Date
3 August 2016
Last Update Date
19 January 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6514392059
Graduation Year
1999 (27 years ago)
PAC ID
1052754298
Group Practice PAC ID
8224131750
Professional Enrollment ID
I20240205003680
Address ID
MN550827596ST1751XWXXX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

1,813 MENTAL HEALTH COUNSELOR in MN

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Provider Addresses for MRS. JULIE ANNE DE WILDE (M.A., LPCC)

  • 1900, Silver Lake Road Northwest, New Brighton, Ramsey County, Minnesota, 55112, United States

    NEW BRIGHTON, MN 551121786

    Phone: (651) 628-9566

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240205003680IMental Health CounselorMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55112)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8224131750View full group profile
NameSpecialtyState
Clinical Social WorkerMN
Marriage And Family TherapistMN
Marriage And Family TherapistMN
Mental Health CounselorMN
Clinical PsychologistMN
Clinical PsychologistFL
Mental Health CounselorFL
Clinical Social WorkerMN
Mental Health CounselorMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

What is the registry number for MRS. JULIE ANNE DE WILDE (M.A., LPCC)?
The registry entry for MRS. JULIE ANNE DE WILDE (M.A., LPCC) shows NPI 1083168314.
Quick check: is MRS. JULIE ANNE DE WILDE (M.A., LPCC) active?
Public NPPES data shows MRS. JULIE ANNE DE WILDE (M.A., LPCC) with an active NPI status right now.
What does the directory say MRS. JULIE ANNE DE WILDE (M.A., LPCC) does?
Insurance directories may phrase it differently, but here MRS. JULIE ANNE DE WILDE (M.A., LPCC) maps to Professional Counselor. Clinical services aligned with this taxonomy classification.
Can patients visit MRS. JULIE ANNE DE WILDE (M.A., LPCC) in New Brighton, Minnesota?
For routing, start with New Brighton, Minnesota for MRS. JULIE ANNE DE WILDE (M.A., LPCC), then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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