Healthcare Provider Details

I. General information

NPI: 1316853039
Provider Name (Legal Business Name): GROUND SWELL WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 EVERNIA ST APT 731
WEST PALM BEACH FL
33401-5474
US

IV. Provider business mailing address

499 EVERNIA ST APT 731
WEST PALM BEACH FL
33401-5474
US

V. Phone/Fax

Practice location:
  • Phone: 203-671-5172
  • Fax: 561-954-3870
Mailing address:
  • Phone: 203-671-5172
  • Fax: 561-954-3870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CHARLES SCHREIER
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: APRN, PMHNP-C
Phone: 203-671-5172