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General NPI Number Information
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NPI Number | 1841141280
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Entity Type | Organization
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Legal Business Name | PADDOCK WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 201 N MITCHELL ST STE 204
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City | CADILLAC
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State | MI
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Zip | 49601-1859
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Country | US
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Telephone | 231-884-0028
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Fax | 888-977-1502
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Provider Business Mailing Address
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Address Line | 201 N MITCHELL ST STE 204
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City | CADILLAC
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State | MI
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Zip | 49601-1859
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Country | US
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Telephone | 231-884-0028
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Fax | 888-977-1502
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Authorized Official
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Title or Position | OWNER, BUSINESS MANAGER
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Name | BRENNA EDWARDS
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Credential | BT
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Telephone | 231-638-5316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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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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