Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1760908263 Individual Practitioner Female Practitioner

Logan Olivia Wilder-Ingram

Counselor - Professional • Hamilton, OH

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Logan Wilder-Ingram is a certified Counselor - Professional practicing in Hamilton, OH. With approximately 4 years of clinical experience since completing medical education in 2022, Logan Wilder-Ingram delivers high-quality medical care to the local community at 1910 FAIRGROVE AVE.

Logan Wilder-Ingram is affiliated with Modern Psychiatry And Wellness Llc and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

1910 Fairgrove Ave

Hamilton, OH 450111930

Telephone 5134944679
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2022

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Hamilton, OH

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
4 Yrs -4.4 yrs vs City Avg
City Avg: 8.4 Yrs
State Avg: 15.9 Yrs
Regional Practice Density
42 Specialists

Practicing in Hamilton, OH (6923 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wilder-Ingram (4 Years) 4 Yrs
Hamilton Specialty Average (8.4 Years) 8.4 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-10-20
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License OH E.2505581

Definition to come...

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License OH LCDCIII.161933

Definition to come...

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License OH C.2204204

Definition to come...

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License OH C.2204204

Definition to come...

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License OH CDCA.167891

Definition to come...

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License OH LICDC.162260

Definition to come...

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License OH CDCA.164220

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0443789 (OH)

Hospital & Practice Group Affiliations

Modern Psychiatry And Wellness Llc

1910 Fairgrove Ave, Hamilton, OH 450111930

Phone: 5137957557

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Deona Justice

Counselor - Addiction (Substance Use Disorder)

NPI 1013554047
Jennifer Brock , LPCC-S

Counselor - Professional

NPI 1023327368

LPCCS

Angela Smith

Counselor - Addiction (Substance Use Disorder)

NPI 1033909361
NPI 1033922257
Kathryn Reese , LISW

Social Worker - Clinical

NPI 1073167375

Licensed Independent Social Worker

Ramsey Jones

Counselor - Addiction (Substance Use Disorder)

NPI 1073460556

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

22 Historical Events
📍
Updated Practice Location October 20, 2025

Registered at 1910 FAIRGROVE AVE, HAMILTON, OH 450111930 (Tel: 5134944679)

📍
Updated Business Mailing Address October 20, 2025

Registered at 1910 FAIRGROVE AVE, HAMILTON, OH 450111930 (Tel: 5134944679)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 20, 2025

Counselor (License #E.2505581 in OH)

📍
Updated Practice Location June 05, 2024

Registered at 1 ELIZABETH PL, DAYTON, OH 454173445 (Tel: 9378131737)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 05, 2024

Counselor (License #LCDCIII.161933 in OH)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 16, 2023

Counselor (License #CDCA.164220 in OH)

📍
Updated Practice Location May 23, 2023

Registered at 160 N BREIEL BLVD, MIDDLETOWN, OH 450423806 (Tel: 5139414999)

📍
Updated Business Mailing Address May 23, 2023

Registered at 6460 HARRISON AVE STE 200, CINCINNATI, OH 452477958 (Tel: 5139414999)

👤
Provider Name / Credentials Updated May 23, 2023

Recorded as LOGAN WILDER-INGRAM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 23, 2023

Counselor (License #LICDC.162260 in OH)

📍
Updated Practice Location August 10, 2021

Registered at 6460 HARRISON AVE, CINCINNATI, OH 452477957 (Tel: 5139414999)

📍
Updated Business Mailing Address August 10, 2021

Registered at 3605 FIESTA WAY, MIDDLETOWN, OH 450446109 (Tel: 5135027014)

👤
Provider Name / Credentials Updated August 10, 2021

Recorded as LOGAN WILDER-INGRAM, LCDC III, CT, QMHS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 10, 2021

Counselor (License #C.2103188-TRNE in OH)

📍
Updated Practice Location May 21, 2021

Registered at 820 S MARTIN LUTHER KING JR BLVD, HAMILTON, OH 450113216 (Tel: 5138878500)

👤
Provider Name / Credentials Updated May 21, 2021

Recorded as LOGAN WILDER-INGRAM, CT, LCDCIII, QMHS

NPI Profile Active August 16, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location August 16, 2017

Registered at 442 S 2ND ST, HAMILTON, OH 450112936 (Tel: 5138684980)

📍
Updated Business Mailing Address August 16, 2017

Registered at 820 S MARTIN LUTHER KING JR BLVD, HAMILTON, OH 450113216

👤
Provider Name / Credentials Updated August 16, 2017

Recorded as LOGAN WILDER, CDCA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 16, 2017

Counselor (License #CDCA.164220 in OH)

🟢
Initial NPI Registration & Enumeration August 16, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1760908263
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 16, 2017
Last Update: October 20, 2025
Sole Proprietor: Yes

Mailing Address

1910 Fairgrove Ave

Hamilton, OH 450111930

Phone: 5134944679

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.