| Wild Wellness Inc. | |
|
449 Pittsfield Rd Ste 105 Lenox MA 01240-2107 | |
| (413) 591-9355 | |
| (413) 429-4342 |
| Full Name | Wild Wellness Inc. |
|---|---|
| Speciality | Counselor |
| Location | 449 Pittsfield Rd Ste 105, Lenox, Massachusetts |
| Authorized Official Name and Position | Eric Krawczyk (OWNER) |
| Authorized Official Contact | 4135919355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Wellness Inc. 230 Middle Rd Austerlitz NY 12017-1725 Ph: (413) 591-9355 | Wild Wellness Inc. 449 Pittsfield Rd Ste 105 Lenox MA 01240-2107 Ph: (413) 591-9355 |
| NPI Number | 1215799093 |
|---|---|
| Provider Enumeration Date | 01/26/2024 |
| Last Update Date | 03/20/2025 |
| Certification Date | 03/20/2025 |
| Medicare PECOS PAC ID | 1759724313 |
|---|---|
| Medicare Enrollment ID | O20240617001212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215799093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Eric Krawczyk |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255721494 PECOS PAC ID: 2668815226 Enrollment ID: I20240617001497 |
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