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NPI Code Detail

MEDICARE: ALLIES IN WELLNESS COLLECTIVE, LLC

MEDICARE: ALLIES IN WELLNESS COLLECTIVE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1407631476
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLIES IN WELLNESS COLLECTIVE, LLC
Provider Business Mailing Address
First Line : 317 EDGEWATER DR
Second Line : SUITE #5811
City : ORLANDO
State : FL
Zip : 32804
Country : US
Telephone Number : 561-281-8846
Fax Number :
Provider Business Practice Location Address
First Line : 1825 RIVERVIEW DR
Second Line :
City : MELBOURNE
State : FL
Zip : 32901-4711
Country : US
Telephone Number : 561-281-8846
Fax Number :
Authorized Official
Title or Position : OWNER/CEO
Name : MRS. REBECCA THIPSINGH
Credential : LCSW, TCT
Telephone Number : 321-258-9537
Provider Enumeration Date : 08/29/2023
Last Update Date : 08/29/2023

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Directions to “ALLIES IN WELLNESS COLLECTIVE, LLC ” Practice Location

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