Healthcare Provider Details

I. General information

NPI: 1124613377
Provider Name (Legal Business Name): INTUITION WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 03/09/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 SOUTHPARK CIR E
SAINT AUGUSTINE FL
32086-5137
US

IV. Provider business mailing address

224 RIVER PLANTATION RD S
SAINT AUGUSTINE FL
32092-8959
US

V. Phone/Fax

Practice location:
  • Phone: 808-258-8089
  • Fax:
Mailing address:
  • Phone: 808-258-8089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMANDA W SWARTZLENDER
Title or Position: OWNER
Credential: LMHC
Phone: 808-258-8089