Healthcare Provider Details

I. General information

NPI: 1326942194
Provider Name (Legal Business Name): SHEI WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3860 TEAYS VALLEY RD STE 4
HURRICANE WV
25526-9772
US

IV. Provider business mailing address

10 CHARLO DR
HURRICANE WV
25526-9288
US

V. Phone/Fax

Practice location:
  • Phone: 304-541-8088
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: BONNI ROACH
Title or Position: MEMBER
Credential: NP
Phone: 304-541-8088