Healthcare Provider Details

I. General information

NPI: 1942037288
Provider Name (Legal Business Name): ESSENTIAL MENTAL WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 N THOMPSON LN STE 1B
MURFREESBORO TN
37129-4340
US

IV. Provider business mailing address

PO BOX 1992
BRENTWOOD TN
37024-1992
US

V. Phone/Fax

Practice location:
  • Phone: 615-260-8058
  • Fax: 615-468-4660
Mailing address:
  • Phone: 615-260-8058
  • Fax: 615-468-4660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PHILIP A. BROOKS
Title or Position: PRESIDENT/CEO/PHYSICIAN
Credential: MD
Phone: 615-260-8058