# WILSON RIDGE LLC

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

## Provider details

- **NPI number:** 1427913649
- **Authorized official:** AUTUMN WILSON LPCC (CLINICAL COUNSELOR)
- **Authorized official phone:** (763) 567-3875

## Contact information

- **Practice address:** 1884 MAHOGANY ST, MORA, MN 55051-7111
- **Practice address phone:** (763) 567-3875
- **Mailing address:** 7145 375TH AVE NW, DALBO, MN 55017-8403
- **Mailing address phone:** (763) 567-3877

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 12/19/2025
- **Last updated:** 12/19/2025