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General NPI Number Information
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NPI Number | 1598657132
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Entity Type | Organization
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Legal Business Name | FAMILY MENTAL HEALTH WELLNESS LLC
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 424 MAIN ST
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City | HILLSBORO
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State | MO
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Zip | 63050-4350
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Country | US
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Telephone | 636-208-5484
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Fax | 800-246-0622
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Provider Business Mailing Address
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Address Line | 424 MAIN ST
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City | HILLSBORO
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State | MO
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Zip | 63050-4350
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Country | US
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Telephone | 636-208-5486
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Fax | 800-246-0622
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Authorized Official
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Title or Position | OWNER
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Name | DANIELLE KENNEDY
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Credential |
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Telephone | 636-208-5486
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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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