Healthcare Provider Details

I. General information

NPI: 1538923610
Provider Name (Legal Business Name): THE WELLNESS COMPANY X, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2024
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W CHERRY ST
NEVADA MO
64772-2202
US

IV. Provider business mailing address

300 W CHERRY ST
NEVADA MO
64772-2202
US

V. Phone/Fax

Practice location:
  • Phone: 417-667-4230
  • Fax:
Mailing address:
  • Phone: 417-667-4230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CLARA MICHELLE LYNN SANDS
Title or Position: OWNER/OPERATOR
Credential: LCSW
Phone: 417-448-9437