| Wildflower Collective Llc | |
|
5824 S 142nd St Ste A Omaha NE 68137-2872 | |
| (402) 205-5120 | |
| Not Available |
| Full Name | Wildflower Collective Llc |
|---|---|
| Speciality | Counselor |
| Location | 5824 S 142nd St Ste A, Omaha, Nebraska |
| Authorized Official Name and Position | Jessica Wisneski (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Contact | 4022055120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wildflower Collective Llc 2809 S 160th St Ste 101 Omaha NE 68130-1755 Ph: (402) 205-5120 | Wildflower Collective Llc 5824 S 142nd St Ste A Omaha NE 68137-2872 Ph: (402) 205-5120 |
| NPI Number | 1043946627 |
|---|---|
| Provider Enumeration Date | 07/27/2022 |
| Last Update Date | 11/12/2025 |
| Certification Date | 11/12/2025 |
| Medicare PECOS PAC ID | 9335594563 |
|---|---|
| Medicare Enrollment ID | O20231009001648 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043946627 | NPI | - | NPPES |
| 50727896000 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Natalie Mckenzie Scarpa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083205090 PECOS PAC ID: 0244685477 Enrollment ID: I20231009001768 |
| Provider Name | Mackenzie B Parks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154806701 PECOS PAC ID: 1355799693 Enrollment ID: I20231128001985 |
| Provider Name | Kaitlyn Taylor Runyon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073233540 PECOS PAC ID: 5294261046 Enrollment ID: I20241204001341 |
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