Organization Active NPI

The Wild Within Counseling and Holistic Therapy Group, PLLC

  • Clinical Social Worker
  • Mesa, AZ
National Provider Identifier
1649086505
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
THE WILD WITHIN COUNSELING AND HOLISTIC THERAPY GROUP, PLLC
Practice address
2160 E Brown Rd Ste 3
Mesa, AZ 85213-5250
Phone
(480) 771-2181
NPI assigned
Dec 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Authorized official

Name
Alicja Emilia Adamczyk Wright, LCSWNPI 1700547049
Title
Owner/Therapist
Phone
(480) 528-7185

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

2160 E Brown Rd Ste 3
Mesa, AZ 85213-5250

Mailing address

5431 E Greenway St
Mesa, AZ 85205-4360
Phone (480) 528-7185

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1649086505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5431 E GREENWAY ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054360",
            "telephone_number": "480-528-7185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 E BROWN RD STE 3",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852135250",
            "telephone_number": "480-771-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WILD WITHIN COUNSELING AND HOLISTIC THERAPY GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "ALICJA",
        "authorized_official_middle_name": "EMILIA ADAMCZYK",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "480-528-7185",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.