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

Nicole R Wildroudt, LPCC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1235526096

Nicole R Wildroudt, LPCC is a Mental Health Counselor in Kokomo, Indiana. Qualified in 2019, 7 years ago. Practices with El Rio Santa Cruz Neighborhood Health Center, Inc, a 283-clinician group and accepts Medicare assignment. Licensed in Arizona, Indiana and Ohio.

Years since qualifying
7
Licensed in
AZ, IN, OH
In the registry since
2015
Specialties on file
4
What do these letters mean?
LPCC — Licensed Professional Clinical Counselor
The title some states use for a licensed clinical counsellor.

See every abbreviation used in this directory →

Practice location Address checks out

4104 Springmill Dr
Kokomo, IN 46902-5168
Phone: (937) 554-3667
Show map & directions

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

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LPC-24135 (AZ)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 86000458A (IN)
Professional Counselor Taxonomy 101YP2500X · Licence E.2606445 (OH)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence LICDC.162012 (OH)

Record details

NPI number1235526096
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPCC
Sole proprietorNo
NPI enumeratedApril 20, 2015
Last updated in NPPESJuly 29, 2026
Certification dateJuly 29, 2026

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 El Rio Santa Cruz Neighborhood Health Center, Inc. — 283 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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