Wild Hearts Rise

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

WILD HEARTS RISE

Practice address

1345 E Chandler Blvd Ste 107
Phoenix, AZ 85048-6280

Phone

(480) 310-0790

NPI assigned

Mar 9, 2020

Organization subpart

No

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

Authorized official

Name

Valerie Shand, LCSW

Title

Ceo

Phone

(480) 310-0790

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Valerie Kashishi, LCSW

  • Clinical Social Worker
  • Gilbert, AZ
  • NPI 1285082131
  NPD (past)

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

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583712000000",
    "number": "1265067334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 E CHANDLER BLVD STE 107",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850486280",
            "telephone_number": "480-310-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 E CHANDLER BLVD STE 107",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850486280",
            "telephone_number": "480-310-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD HEARTS RISE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-09",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A",
        "authorized_official_last_name": "SHAND",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-310-0790",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wiivv Wearables
• Tasha Wilbur, RBT
• Megan Rose Wilcott
• Amanda Wilcox, COTA/L
• Lauren Wilcox, PA-C
• Wild Roots Wellness, PLLC
• Wild Terrain Therapy LLC
• Jennifer Wild, D.O.
• Reece Wild, PA-C
• Susanne Gertraud Wild, M.D.

• Adult Mental Health Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Adult Mental Health Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; 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.