MENTAL WELLNESS CENTER INC NPI 1629596812

NPI Information

NPI: 1629596812
Provider Name: MENTAL WELLNESS CENTER INC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
205 N WILLIAMSBURG DR STE A
BLOOMINGTON, IL
ZIP 61704
Phone: (309) 807-5077
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MENTAL WELLNESS CENTER INC is a professional counselor in Bloomington, IL. MENTAL WELLNESS CENTER INC NPI is 1629596812. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

205 N WILLIAMSBURG DR STE A
BLOOMINGTON, IL
ZIP 61704-721
Phone: (309) 807-5077
Fax: (309) 214-9679

The provider's authorized official is Jennifer Rae Bovee .
The authorized official title is Group Practice Owner and has the following contact phone number (309) 807-5077.

The enumeration date for this NPI number is 9/7/2017 and was last updated on 8/27/2021.

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
1	101YP2500X	Counselor	Professional			Yes

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: 11/14/2023

NPI Synchronization or Removal

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