Holly Wigmore, LPC
Counselor, Mental Health in Portland, OR. Individual provider (NPI-1).
NPI number1093440539
StatusActive
Last updated in NPPESFeb 28, 2025
Details
- NPI
- 1093440539
- Entity type
- Individual (NPI-1)
- Name
- Ms. Holly Wigmore
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 19, 2022
- Certification date
- Feb 28, 2025
- Last updated
- Feb 28, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - MENTAL HEALTH COUNSELOR
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | C8931 | OR | Yes |
Practice location
1110 Se Alder St Ste 301Portland, OR 97214-2400
Phone 503-843-8862
Mailing address
1110 Se Alder St Ste 301Portland, OR 97214-2400
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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