Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Brandon J Wilde, CMHC

Individual provider Mental Health Counselor · NPI 1710140447

Dr. Brandon J Wilde, CMHC is a Mental Health Counselor in Provo, Utah. Practices as a sole proprietor and works from 2 locations. Licensed in Arizona, Idaho, Nevada and Utah.

Licensed in
AZ, ID, NV, UT
In the registry since
2008
Specialties on file
5

Practice location Address checks out

122 E 1700 S Bldg 3
Provo, UT 84606-5644
Phone: (801) 900-3656
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4460 Central Way, Chubbuck, ID 83202 — (208) 237-1711

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 9471022-6044 (UT)
Mental Health Counselor Taxonomy 101YM0800X · Licence 9471002-6004 (UT)
Mental Health Counselor Taxonomy 101YM0800X · Licence LPC3887 (ID)
Mental Health Counselor Taxonomy 101YM0800X · Licence LPC-17502 (AZ)
Professional Counselor Taxonomy 101YP2500X · Licence CP3313-R (NV)

Record details

NPI number1710140447
Entity typeIndividual (Type 1)
GenderMale
Credentials CMHC
Sole proprietorYes
NPI enumeratedJuly 2, 2008
Last updated in NPPESSeptember 10, 2024
Certification dateSeptember 10, 2024

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