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

Logan Olivia Wilder-Ingram

Individual provider Professional Counselor · NPI 1760908263

Logan Olivia Wilder-Ingram is a Mental Health Counselor in Hamilton, Ohio. Qualified in 2022, 4 years ago. Practices with Modern Psychiatry and Wellness LLC, a 24-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
4
Licensed in
OH
In the registry since
2017
Specialties on file
7

Practice location Address checks out

1910 Fairgrove Ave
Hamilton, OH 45011-1930
Phone: (513) 494-4679
Show map & directions

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

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence E.2505581 (OH)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence LCDCIII.161933 (OH)
Mental Health Counselor Taxonomy 101YM0800X · Licence C.2204204 (OH)
Mental Health Counselor Taxonomy 101YM0800X · Licence C.2204204 (OH)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence CDCA.167891 (OH)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence LICDC.162260 (OH)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence CDCA.164220 (OH)

Record details

NPI number1760908263
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 16, 2017
Last updated in NPPESOctober 20, 2025
Certification dateOctober 20, 2025
Mailing address1910 Fairgrove Ave, Hamilton, OH 45011-1930

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Modern Psychiatry And Wellness Llc — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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