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General NPI Number Information
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NPI Number | 1114781010
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Entity Type | Organization
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Legal Business Name | TOTAL WELLNESS MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 02/12/2024
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 249 CENTRAL PARK AVE STE 300-160
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3099
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Country | US
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Telephone | 757-761-5815
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Fax |
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Provider Business Mailing Address
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Address Line | 136 CARTWELL DR APT 101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-1420
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Country | US
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Telephone | 757-761-5815
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KANISHA BELT
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Credential | PMHNP-BC
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Telephone | 757-761-5815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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