Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ellicia Wilder, LPC-IT, SAC-IT

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1861156473

Ellicia Wilder, LPC-IT, SAC-IT is a Mental Health Counselor in Milwaukee, Wisconsin. Qualified in 2019, 7 years ago. Practices with Gerald L Ignace Indian Health Center Inc, a 14-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
7
Licensed in
WI
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

930 W Historic Mitchell St
Milwaukee, WI 53204-3533
Phone: (414) 383-9526
Fax: (414) 671-6606
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 4482-226 (WI)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 18729-130 (WI)

Record details

NPI number1861156473
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC-IT , SAC-IT
Sole proprietorNo
NPI enumeratedOctober 29, 2021
Last updated in NPPESNovember 1, 2021
Certification dateNovember 1, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Gerald L Ignace Indian Health Center Inc — 14 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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