Healthcare Provider Details

I. General information

NPI: 1083322259
Provider Name (Legal Business Name): JEANNIE WELLS, LPC P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1170 RICHMOND CT
MOBILE AL
36695-3557
US

IV. Provider business mailing address

1170 RICHMOND CT
MOBILE AL
36695-3557
US

V. Phone/Fax

Practice location:
  • Phone: 251-422-0346
  • Fax:
Mailing address:
  • Phone: 251-422-0346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JEANNIE WELLS-POIRIER
Title or Position: THERAPIST
Credential: MS LPC
Phone: 251-367-8191