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General NPI Number Information
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NPI Number | 1003375684
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Entity Type | Organization
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Legal Business Name | FEELWELL LLC
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 03/13/2019
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Provider Practice Location Address
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Address Line | 67 COOPER ST
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City | WOODBURY
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State | NJ
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Zip | 08096-4628
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Country | US
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Telephone | 856-631-3498
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Fax |
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Provider Business Mailing Address
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Address Line | 163 STANHOPE AVE
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City | MANTUA
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State | NJ
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Zip | 08051-1165
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Country | US
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Telephone | 856-889-1505
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHANNON YATES
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Credential | LPC
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Telephone | 856-631-3498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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