Healthcare Provider Details

I. General information

NPI: 1962129833
Provider Name (Legal Business Name): SPECIAL WELLNESS CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2022
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1972 S CONGRESS AVE
WEST PALM BEACH FL
33406-6674
US

IV. Provider business mailing address

1972 S CONGRESS AVE
WEST PALM BEACH FL
33406-6674
US

V. Phone/Fax

Practice location:
  • Phone: 561-705-5610
  • Fax: 561-405-7335
Mailing address:
  • Phone: 561-705-5610
  • Fax: 561-405-7335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DENISLEYDIS DENIS
Title or Position: OFFICER
Credential: LCSW
Phone: 561-705-5610