Healthcare Provider Details

I. General information

NPI: 1225921067
Provider Name (Legal Business Name): ACCESS WELLNESS & CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

273 S WASHINGTON ST
TIFFIN OH
44883-3052
US

IV. Provider business mailing address

273 S WASHINGTON ST
TIFFIN OH
44883-3052
US

V. Phone/Fax

Practice location:
  • Phone: 419-314-0231
  • Fax: 419-540-4991
Mailing address:
  • Phone: 419-314-0231
  • Fax: 419-540-4991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLIE PALMER
Title or Position: NURSE PRACTITIONER
Credential: CNP
Phone: 567-230-1162