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General NPI Number Information
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NPI Number | 1548130685
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Entity Type | Organization
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Legal Business Name | WILD HOPE, LLC
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Dates
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Enumeration Date | 11/05/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 171 CHESTNUT ST STE 200
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City | PROVIDENCE
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State | RI
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Zip | 02903-4604
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Country | US
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Telephone | 508-208-3480
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Fax |
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Provider Business Mailing Address
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Address Line | 171 CHESTNUT ST STE 200
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City | PROVIDENCE
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State | RI
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Zip | 02903-4604
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Country | US
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Telephone | 401-484-1605
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | SARAH LEACH
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Credential | LICSW
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Telephone | 508-208-3480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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