Healthcare Provider Details
I. General information
NPI: 1356157838
Provider Name (Legal Business Name): WELLNESS PSYCHIATRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/09/2024
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1658 COLE BLVD STE 210
LAKEWOOD CO
80401-3304
US
IV. Provider business mailing address
1658 COLE BLVD STE 210
LAKEWOOD CO
80401-3304
US
V. Phone/Fax
- Phone: 303-747-5051
- Fax: 724-204-1648
- Phone: 303-747-5051
- Fax: 724-204-1648
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMANDA
FARRELL
Title or Position: OWNER, PMHNP
Credential: NP
Phone: 303-747-5051