Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wild Terrain Therapy LLC

Organization Clinical Social Worker · NPI 1538912134

Wild Terrain Therapy LLC provides Clinical Social Worker services in Phoenix, Arizona. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11811 N Tatum Blvd
Phoenix, AZ 85028-1614
Phone: (480) 721-9593
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1538912134
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Danielle Bosma — Ceo · (480) 798-2498
NPI enumeratedApril 11, 2024
Last updated in NPPESApril 11, 2024
Certification dateApril 11, 2024
Mailing addressPo Box 31853, Phoenix, AZ 85046-1853

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