Healthcare Provider Details

I. General information

NPI: 1821965187
Provider Name (Legal Business Name): ATARAXIA WELLNESS PROJECT NORTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25371 STORMS RD
WEST MANSFIELD OH
43358-9665
US

IV. Provider business mailing address

25371 STORMS RD
WEST MANSFIELD OH
43358-9665
US

V. Phone/Fax

Practice location:
  • Phone: 937-210-9116
  • Fax:
Mailing address:
  • Phone: 937-210-9116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MISS AMANDA FAYE PRICE
Title or Position: OWNER
Credential: LISW-S, LCSW
Phone: 740-262-8710