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General NPI Number Information
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NPI Number | 1891539094
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Entity Type | Organization
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Legal Business Name | I AM WELL CONSULTING, LLC
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Dates
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Enumeration Date | 06/21/2024
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 103 CONTINENTAL PL STE 204
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City | BRENTWOOD
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State | TN
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Zip | 37027-1041
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Country | US
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Telephone | 615-543-6589
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Fax |
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Provider Business Mailing Address
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Address Line | 6216 DEL SOL DR
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City | WHITES CREEK
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State | TN
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Zip | 37189-2902
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Country | US
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Telephone | 731-694-2839
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARYAM ABDALLAH
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Credential | LCSW
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Telephone | 731-694-2839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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