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Phoenix Rebellion Therapy, LLC

Clinical Social Worker in Murray, UT · enumerated 2020 · authorized official Rod Waller, President/Exec Director.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1134759186

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Registry record

Entity type Organization (Type 2)
Legal business name Phoenix Rebellion Therapy, LLC
Practice address 4516 S 700 E Ste 360, Murray, UT, 84107
Phone (385) 231-8387
Fax (385) 240-3843
Enumeration date Jan 17, 2020
Last updated in NPPES Jan 18, 2023

Taxonomy & classification

1041C0700X Clinical Social Worker Behavioral Health & Social Service Providers Primary

Authorized official

Name Rod Waller
Title President/Exec Director
Phone (385) 231-8387

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Phoenix Rebellion Therapy, LLC?
The NPI for Phoenix Rebellion Therapy, LLC is 1134759186, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Phoenix Rebellion Therapy, LLC?
NPPES lists Rod Waller (President/Exec Director) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2023-01-18.