THAD WILDERSON & ASSOCIATES PA NPI 1306973698

NPI Information

  • NPI: 1306973698
  • Provider Name: THAD WILDERSON & ASSOCIATES PA
  • Classification: Psychologist - 103TC2200X
  • Specialization: Clinical Child & Adolescent
  • Entity Type: Organization
  • Address: 475 UNIVERSITY AVE W
    SAINT PAUL, MN
    ZIP 55103
  • Phone: (651) 225-8997

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NPI Details

THAD WILDERSON & ASSOCIATES PA is a clinical child and adolescent psychologist in Saint Paul, MN. The provider is a psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents. THAD WILDERSON & ASSOCIATES PA NPI is 1306973698. The provider is registered as an organization entity type.

The provider's business location address is:

475 UNIVERSITY AVE W
SAINT PAUL, MN
ZIP 55103-959
Phone: (651) 225-8997
Fax: (651) 225-1967

The provider's authorized official is Thad Wilfred Wilderson .
The authorized official title is Executive Director and has the following contact phone number (651) 225-8997.

The enumeration date for this NPI number is 2/27/2007 and was last updated on 9/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251B00000XCase ManagementLP0061MINNESOTANo
2103TC2200XPsychologistClinical Child & AdolescentYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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