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

Willow Nichole Wilde, LCSW

Individual provider Clinical Social Worker · NPI 1205616018

Willow Nichole Wilde, LCSW is a Clinical Social Worker in Springfield, Oregon. Qualified in 2023, 3 years ago. Practices with Mindful Therapy Group PC, a 646-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
3
Licensed in
OR
In the registry since
2023
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

1238 S 58th St
Springfield, OR 97478-5474
Phone: (541) 698-1805
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence L17959 (OR)

Record details

NPI number1205616018
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedOctober 2, 2023
Last updated in NPPESApril 30, 2026
Certification dateApril 30, 2026

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Mindful Therapy Group Pc — 646 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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