Wild & Well Recovery LLC

Primary specialty

Rehabilitation PsychologistTaxonomy code 103TR0400X

Legal business name

WILD & WELL RECOVERY LLC

Practice address

211 E Campo Desierto Rd
Tempe, AZ 85288-1161

Phone

(435) 669-6669

NPI assigned

Mar 14, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Adam Ahquin, PSYCHOLOGY

Title

Executive Director

Phone

(435) 669-6669

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678752000000",
    "number": "1205537693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 354",
            "city": "LA VERKIN",
            "state": "UT",
            "postal_code": "847450354",
            "telephone_number": "435-669-6669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E CAMPO DESIERTO RD",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852881161",
            "telephone_number": "435-669-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD & WELL RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-10",
        "status": "A",
        "authorized_official_last_name": "AHQUIN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "435-669-6669",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PSYCHOLOGY"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Lofgreen Whyte, D.C.
• Beth Wieland, PT, DPT, CSCS
• Jacqueline Wiersma, PT
• James Brandon Wiese, PHARMD
• Kelly Wilcox, MS, OTR/L
• Wild Willow Counseling, PLLC
• Charles Wilder
• Julie Wilder, LPC
• Justin Cole Wilder, PHARMD, RPH, MED
• Wildflower Wellness Therapy

• Rehabilitation Psychologist in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Rehabilitation Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.