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

Wild Mind Therapy PLLC

Organization Clinical Social Worker · NPI 1437965100

Wild Mind Therapy PLLC is a Clinical Social Worker in Wilson, New York. Registered with an NPI since 2024.

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

See every abbreviation used in this directory →

Practice location Address checks out

4648 Ide Rd
Wilson, NY 14172-9758
Phone: (716) 727-8803
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1437965100
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Debra Wrazin — President · (716) 727-8803
NPI enumeratedDecember 9, 2024
Last updated in NPPESDecember 9, 2024
Certification dateNovember 17, 2024
Mailing address4662 Ide Rd, Wilson, NY 14172-9758