Provider Demographics
NPI:1962256297
Name:WISDOM WELL THERAPY, PLLC
Entity type:Organization
Organization Name:WISDOM WELL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DILGER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:512-240-2876
Mailing Address - Street 1:202 WALTON WAY
Mailing Address - Street 2:STE 192 PMB 440
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613
Mailing Address - Country:US
Mailing Address - Phone:512-240-2876
Mailing Address - Fax:
Practice Address - Street 1:1813 WOODSTONE CT
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-6803
Practice Address - Country:US
Practice Address - Phone:512-240-2876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty