Phoenix Rebellion Therapy, LLC
NPI 1134759186 · Clinical Social Worker · Murray, UT
Phoenix Rebellion Therapy, LLC is a Clinical Social Worker organization in Murray, UT (NPI 1134759186).
Provider details
- NPI number
- 1134759186
- Entity type
- Organization
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Rod Waller, President/Exec Director(385) 231-8387
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 347 N 300 W Ste 201Kaysville, UT 84037-1828Phone: (385) 231-8387Fax: (385) 240-3843
Registry dates
- Enumerated
- 2020-01-17
- Last updated
- 2023-01-18
- Certified
- 2023-01-18
Frequently asked questions
- What is Phoenix Rebellion Therapy, LLC's NPI number?
- Phoenix Rebellion Therapy, LLC's National Provider Identifier (NPI) is 1134759186, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Phoenix Rebellion Therapy, LLC?
- Phoenix Rebellion Therapy, LLC is classified in the NPPES registry as Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Phoenix Rebellion Therapy, LLC located?
- Phoenix Rebellion Therapy, LLC's practice location on file with NPPES is 4516 S 700 E Ste 360, Murray, UT 84107-8317.
- What is Phoenix Rebellion Therapy, LLC's phone number?
- The practice phone number listed in the NPPES registry for Phoenix Rebellion Therapy, LLC is (385) 231-8387.
- Who is the authorized official for Phoenix Rebellion Therapy, LLC?
- The authorized official listed on Phoenix Rebellion Therapy, LLC's NPPES record is Rod Waller, President/Exec Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Phoenix Rebellion Therapy, LLC's NPI active?
- Yes — Phoenix Rebellion Therapy, LLC's NPI (1134759186) is active in the NPPES registry as of the last update on 2023-01-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.