Wild Recovery LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

WILD RECOVERY LLC

Practice address

1250 Moore Lake Dr E Ste 210
Fridley, MN 55432-5135

Phone

(612) 201-2280

NPI assigned

Mar 24, 2025

Organization subpart

No

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

Authorized official

Name

Tracy Lee Alvin Doerr, LPCC, LADCNPI 1194492025

Title

Ceo/LPCC/Ladc

Phone

(612) 201-2280

Specialties & licenses 2

Addresses

Tax ID family

Wild Recovery LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wild Recovery LLC

  • Substance Abuse Rehabilitation Facility
  • Fridley, MN
  • NPI 1659245330
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Wild Recovery LLC

  • Substance Abuse Rehabilitation Facility
  • Fridley, MN
  • NPI 1659245330
  NPPES parent name

Practitioners 2

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

• Tracy Doerr, LPCC/LADC

  • Mental Health Counselor
  • Coon Rapids, MN
  • NPI 1194492025
  NPD Authorized official
• Camille Jensen, MA, LPCC, LADC

  • Professional Counselor
  • Fridley, MN
  • NPI 1174277727
  NPD (past)

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782172800000",
    "number": "1780485854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 MOORE LAKE DR E STE 210",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325135",
            "telephone_number": "612-201-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 MOORE LAKE DR E STE 210",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325135",
            "telephone_number": "612-201-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-24",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A",
        "authorized_official_last_name": "DOERR",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "LEE ALVIN",
        "authorized_official_title_or_position": "CEO/LPCC/LADC",
        "authorized_official_telephone_number": "612-201-2280",
        "authorized_official_credential": "LPCC, LADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tera White
• Jeff A Wiens Heinsohn
• Donald Eugene Wiger II, MD
• Wild & Free Counseling
• Wild Recovery LLC
• William Louis Wilkie, DMD
• Ebony Shawntil Williams
• Jeff Williams
• Jennifer Leanne Williams, P.T.
• Nanette Williams, LMT, L.E.

• Substance Abuse Rehabilitation Facility in Fridley, MN
• Providers in Fridley, MN by specialty
• Substance Abuse Rehabilitation Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; 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.