Healthcare Provider Details

I. General information

NPI: 1548186364
Provider Name (Legal Business Name): THE KIE: WELLNESS COLLECTIVE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E REGENT ST
INGLEWOOD CA
90301-1689
US

IV. Provider business mailing address

215 E REGENT ST APT 333
INGLEWOOD CA
90301-1827
US

V. Phone/Fax

Practice location:
  • Phone: 301-310-8692
  • Fax:
Mailing address:
  • Phone: 301-310-8692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KIERRA WASHINGTON
Title or Position: PSYCHIATRIC MENTAL HEALTH NP
Credential: DNP, APRN, PMHNP-BC
Phone: 301-310-8692