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General NPI Number Information
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NPI Number | 1679384838
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Entity Type | Organization
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Legal Business Name | WELLNESS TRANSFORMED
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 303 E ARMY TRAIL RD STE 417
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2155
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Country | US
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Telephone | 630-442-0050
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Fax |
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Provider Business Mailing Address
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Address Line | 3S101 ROCKWELL ST UNIT 462
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City | WARRENVILLE
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State | IL
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Zip | 60555-2963
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Country | US
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Telephone | 630-442-0050
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | JENALEIGH TURNER
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Credential | LCSW
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Telephone | 630-442-0050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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