Healthcare Provider Details

I. General information

NPI: 1154250025
Provider Name (Legal Business Name): BWELL&WHOLE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1713 HIGHWAY 280 BYP
PHENIX CITY AL
36867-5443
US

IV. Provider business mailing address

8 WINTER HAWK DR
FORT MITCHELL AL
36856-5628
US

V. Phone/Fax

Practice location:
  • Phone: 706-573-2906
  • Fax:
Mailing address:
  • Phone: 706-573-2906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. BRANDI FORD
Title or Position: LPC/PSYCHOTHERAPIST
Credential: M.S, LPC
Phone: 706-573-2906