| Mr Tobias Allen Wilde Sr, MSW, LICSW | |
| 
					4422 30th Ave S Apt 309, Fargo, ND 58104-8441  | |
| (801) 548-8535 | |
| Not Available | 
| Full Name | Mr Tobias Allen Wilde Sr | 
|---|---|
| Gender | Male | 
| Speciality | Social Worker - Clinical | 
| Location | 4422 30th Ave S Apt 309, Fargo, North Dakota | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1770866485 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 5797 (North Dakota) | Secondary | 
| 1041C0700X | Social Worker - Clinical | 24970 (Minnesota) | Primary | 
| Entity Name | Grow Healthcare Group Pa | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20230310000874  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mr Tobias Allen Wilde Sr, MSW, LICSW 4422 30th Ave S Apt 309, Fargo, ND 58104-8441 Ph: (801) 548-8535  | Mr Tobias Allen Wilde Sr, MSW, LICSW 4422 30th Ave S Apt 309, Fargo, ND 58104-8441 Ph: (801) 548-8535  | 
Rachel Marsolek, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 721 1st Ave N, Fargo, ND 58102 Phone: 701-461-7364  | |
Brittany Joy Alexander,  Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2101 Elm St N, Fargo, ND 58102 Phone: 701-232-3241  | |
Tracy E Mohn, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 100 4th St S, Fargo, ND 58103 Phone: 701-234-3106 Fax: 701-234-3106  | |
Rachel Salquist, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2101 Elm St N, Fargo, ND 58102 Phone: 701-232-3241  | |
Tracy M Foldesi-penas, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 100 4th St S, Fargo, ND 58103 Phone: 701-234-3100 Fax: 701-234-3120  | |
Lindsey Leigh Krueger, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 6046 14th St S, Fargo, ND 58104 Phone: 701-404-0997 Fax: 701-566-8876  | |
Deonne J Varriano, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2624 9th Ave S, Fargo, ND 58103 Phone: 701-298-4500 Fax: 701-298-4400  |