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General NPI Number Information
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NPI Number | 1245806710
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Entity Type | Organization
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Legal Business Name | MOTIVATED WELLNESS SOLUTIONS, LLC
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Dates
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Enumeration Date | 06/03/2021
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 185 S LIBERTY ST
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City | POWELL
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State | OH
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Zip | 43065-7619
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Country | US
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Telephone | 740-233-6357
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Fax |
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Provider Business Mailing Address
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Address Line | 303 TOWNSHIP ROAD 208 N
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City | DE GRAFF
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State | OH
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Zip | 43318-9745
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Country | US
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Telephone | 740-233-6357
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | MRS. AMY SMITKE
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Credential | LISW-S, LICDC
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Telephone | 740-233-6357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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