Nicole Wildeman
NPI 1417605833ActiveIndividual· Counselor, Professional· Fenton, MI
Counselor, Professional with Brightside Medical of Michigan PC, practicing in Fenton, Michigan. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1417605833 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Mar 15, 2022 |
| Last updated in NPPES | Apr 9, 2026 |
| Certified by provider | Apr 9, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Professional Primary | 101YP2500X | 6401222623 | MI |
| Counselor, Mental Health | 101YM0800X | TPMC5026 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (MI) |
|---|
Education and affiliations
| Graduation year | 2014 |
|---|---|
| Medicare specialty | Mental Health Counselor |
| Telehealth | Offers telehealth |
Medical group
- Brightside Medical of Michigan PCAtlanta, GA · 91 clinicians
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