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 is a Clinical Social Worker 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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