THE WELLNESS SPACE NPI 1194695452

NPI Information

  • NPI: 1194695452
  • Provider Name: THE WELLNESS SPACE
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 1331 UNION AVE STE 1152
    MEMPHIS, TN
    ZIP 38104
  • Phone: (901) 450-3995

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NPI Details

THE WELLNESS SPACE is a psychiatric/mental health nurse practitioner in Memphis, TN. THE WELLNESS SPACE NPI is 1194695452. The provider is registered as an organization entity type.

The provider's business location address is:

1331 UNION AVE STE 1152
MEMPHIS, TN
ZIP 38104-509
Phone: (901) 450-3995
Fax: (901) 450-3995

The provider's authorized official is Chante Smith-fason .
The authorized official title is Ceo and has the following contact phone number (901) 450-3995.

The enumeration date for this NPI number is 11/10/2025 and was last updated on 11/10/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
2363LF0000XNurse PractitionerFamilyNo
3363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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