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General NPI Number Information
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NPI Number | 1912655986
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Entity Type | Organization
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Legal Business Name | WELLNESS IN MIND, LLC
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 14212 PALLADIUM DR APT 303
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City | MIDLOTHIAN
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State | VA
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Zip | 23114-6808
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Country | US
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Telephone | 804-638-8941
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Fax |
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Provider Business Mailing Address
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Address Line | 14241 MIDLOTHIAN TPKE UNIT 186
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City | MIDLOTHIAN
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State | VA
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Zip | 23113-6500
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Country | US
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Telephone | 804-638-8941
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | PATRICE GRIFFIN
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Credential | LCSW
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Telephone | 804-638-8931
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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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