# WILD INDIGO COUNSELING COLLECTIVE

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

## Provider details

- **NPI number:** 1588528905
- **Authorized official:** JANE TASTET MA, LCMHCA (CO-OWNER/ PSCYHOTHERAPIST)
- **Authorized official phone:** (336) 296-8188

## Contact information

- **Practice address:** 5203 AMBERHILL DR, GREENSBORO, NC 27455-2211
- **Practice address phone:** (336) 296-8188
- **Practice address fax:** (336) 281-5461
- **Mailing address:** 5203 AMBERHILL DR, GREENSBORO, NC 27455-2211
- **Mailing address phone:** (828) 200-6304
- **Mailing address fax:** (336) 281-5461

## Taxonomy

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

## Other

- **Enumeration date:** 12/10/2025
- **Last updated:** 12/10/2025