# WILD ETHOS FAMILY COUNSELING INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235718354
- **Authorized official:** JILL LUKE (SECRETARY)
- **Authorized official phone:** (931) 539-0373

## Contact information

- **Practice address:** 3148 CARRINGTON LN, COLUMBIA, TN 38401-8642
- **Practice address phone:** (931) 539-0373
- **Mailing address:** PO BOX 315, THOMPSONS STATION, TN 37179-0315
- **Mailing address phone:** (931) 539-0373

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 04/06/2021
- **Last updated:** 04/16/2023