Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

WILD ROOTS THERAPEUTICS
NPI 1922853779
Social Worker - Clinical in Salida, CO

Active since April 23, 2024
134 F ST STE 201, SALIDA, CO 81201(720) 443-4933 Get Directions Write a Review

NPPES record last updated: August 6, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 6, 2026, Dec 11, 2024, May 15, 2024 and 1 more (4 updates tracked since 2024).

About Wild Roots Therapeutics NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILD ROOTS THERAPEUTICS (NPI 1922853779) is a healthcare organization registered as a clinical in Salida, Colorado and active in the NPI registry since April 2024. The organization lists Mamie Tisue, Owner, Clinician, as its authorized official.

NPPES Registry Identity

NPI1922853779
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameWILD ROOTS THERAPEUTICS
Location Address134 F ST STE 201Salida, CO 81201-2160
Mailing Address134 F St Ste 201Salida, CO 81201-2160
Organization SubpartNo
Authorized OfficialMamie TisueOwner, Clinician · (719) 752-5672
Enumeration DateApril 23, 2024
Last NPPES UpdateAugust 6, 20264 updates tracked since enumeration
NPPES CertifiedAugust 6, 2026
NPI 1922853779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
134 F ST STE 201, Salida, CO 81201

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Psychiatric/Mental Health)
134 F ST STE 201
SALIDA, CO 81201
Social Worker (Clinical)
134 F ST STE 201
SALIDA, CO 81201
Social Worker (Clinical)
134 F ST STE 201
SALIDA, CO 81201

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wild Roots Therapeutics's NPI number?

The NPI number for Wild Roots Therapeutics is 1922853779. It was assigned to this organization in the NPPES registry on April 23, 2024.

Where is Wild Roots Therapeutics located?

Wild Roots Therapeutics is located at 134 F St Ste 201, Salida, CO 81201. The listed phone number is (720) 443-4933.

What is Wild Roots Therapeutics's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Wild Roots Therapeutics was last updated on August 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.