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NPI Code Detail

MEDICARE: WISDOM HOUSE OF WELLNESS LLC

MEDICARE: WISDOM HOUSE OF WELLNESS 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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1578410825
Entity Type Code : Organization
Provider Name (Legal Business Name) : WISDOM HOUSE OF WELLNESS LLC
Provider Business Mailing Address
First Line : 400 GALLERIA PKWY SE
Second Line :
City : ATLANTA
State : GA
Zip : 30339-5980
Country : US
Telephone Number : 678-534-5887
Fax Number :
Provider Business Practice Location Address
First Line : 400 GALLERIA PKWY SE
Second Line :
City : ATLANTA
State : GA
Zip : 30339-5980
Country : US
Telephone Number : 678-534-5887
Fax Number :
Authorized Official
Title or Position : CEO/LCSW
Name : SOPHIA PIERRE
Credential :
Telephone Number : 407-914-4956
Provider Enumeration Date : 03/16/2026
Last Update Date : 06/04/2026

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Directions to “WISDOM HOUSE OF WELLNESS LLC ” Practice Location

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