KATHRYN WILDER (MA) – Mental Health Counselor, NPI 1326631417

KATHRYN WILDER (MA) is a healthcare provider. based in Burnsville, Minnesota. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA. They hold a License No. 03046 (MN). The NPI Number for KATHRYN WILDER (MA) is 1326631417

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
KATHRYN WILDER (MA)
NPI
1326631417
Phone
(952) 224-8990
Address
2970 JUDICIAL RD STE 100
Enumeration Date
19 February 2021
Last Update Date
18 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6513739440
Graduation Year
2017 (9 years ago)
PAC ID
7214389196
Group Practice PAC ID
0749624211
Professional Enrollment ID
I20240524002115
Address ID
MN551245529AP7600XWXXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,813 MENTAL HEALTH COUNSELOR in MN

Provider Addresses for KATHRYN WILDER (MA)

  • 2970 JUDICIAL RD STE 100

    BURNSVILLE, MN 553377822

    Phone: (952) 224-8990

    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: 2024-05-24

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
I20240524002115IMental 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 55337)

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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: 0749624211View full group profile
NameSpecialtyState
Marriage And Family TherapistMN
Marriage And Family TherapistMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

What is the standard ID for KATHRYN WILDER (MA) in the U.S.?
In the U.S., KATHRYN WILDER (MA) is identified by NPI 1326631417.
Does the public listing show KATHRYN WILDER (MA) as active?
KATHRYN WILDER (MA)'s NPI record reflects an active status in NPPES.
Which specialty label fits KATHRYN WILDER (MA)?
NPPES ties KATHRYN WILDER (MA) to Mental Health Counselor in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is KATHRYN WILDER (MA) tied to Burnsville, Minnesota?
If you are local to Burnsville, Minnesota, KATHRYN WILDER (MA) may be relevant to your search.
Can I export KATHRYN WILDER (MA)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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