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

Jack Wildwood, PHD

Individual provider Mental Health Counselor · NPI 1205317906

Jack Wildwood, PHD is a Mental Health Counselor in Morrisville, Vermont. Practices as a sole proprietor. Licensed in Vermont.

Licensed in
VT
In the registry since
2018
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

133 Gallery Ln
Morrisville, VT 05661-9057
Phone: (802) 505-9044
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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 097.0135245 (VT)

Record details

NPI number1205317906
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedAugust 22, 2018
Last updated in NPPESDecember 17, 2025
Certification dateDecember 17, 2025
Mailing addressPo Box 287, Hyde Park, VT 05655-0287

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