MEDICARE: WELLNESS WITHIN, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YP2500X	Professional Counselor
2	2084P0800X	Psychiatry Physician
3	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1922596675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLNESS WITHIN, INC.

Provider Business Mailing Address
First Line	:	1770 N PARHAM RD STE 102
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-4658
Country	:	US
Telephone Number	:	804-256-3355
Fax Number	:

Provider Business Practice Location Address
First Line	:	1770 N PARHAM RD STE 102
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-4658
Country	:	US
Telephone Number	:	804-256-3355
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	NEEMA MOORE
Credential	:	DC
Telephone Number	:	804-247-6181

Provider Enumeration Date	:	04/27/2018
Last Update Date	:	08/17/2018

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Directions to “WELLNESS WITHIN, INC. ” Practice Location

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