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General NPI Number Information
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NPI Number | 1609622638
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Entity Type | Organization
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Legal Business Name | PROJECT WELLNESS, LLC
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Dates
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Enumeration Date | 04/29/2024
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 27739 JEFFERSON AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48081-1309
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Country | US
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Telephone | 586-315-2874
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Fax | 586-231-3811
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Provider Business Mailing Address
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Address Line | 23747 GLENBROOK ST
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48082-2505
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | CYNTHIA SHIELDS
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Credential | PMHNP-BC
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Telephone | 586-315-2874
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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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