MEDICARE: ALLIES IN WELLNESS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1447812888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIES IN WELLNESS, LLC

Provider Business Mailing Address
First Line	:	391 COMMERCE PKWY STE 220
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-4209
Country	:	US
Telephone Number	:	321-258-9537
Fax Number	:	321-541-9135

Provider Business Practice Location Address
First Line	:	391 COMMERCE PKWY STE 220
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-4209
Country	:	US
Telephone Number	:	321-258-9537
Fax Number	:	321-541-9135

Authorized Official
Title or Position	:	OWNER
Name	:	REBECCA THIPSINGH
Credential	:	LCSW
Telephone Number	:	321-258-9537

Provider Enumeration Date	:	07/06/2019
Last Update Date	:	07/20/2022

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Directions to “ALLIES IN WELLNESS, LLC ” Practice Location

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