| Wellness Collective Llc | |
| 
					3929 Airport Blvd Ste 2-204 Mobile AL 36609-2241  | |
| (251) 480-0070 | |
| (251) 480-0097 | 
| Full Name | Wellness Collective Llc | 
|---|---|
| Speciality | Counselor | 
| Location | 3929 Airport Blvd Ste 2-204, Mobile, Alabama | 
| Authorized Official Name and Position | Amy Collins (CEO) | 
| Authorized Official Contact | 2516101618 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Wellness Collective Llc Po Box 851807 Mobile AL 36685-1807 Ph: (251) 480-0070  | Wellness Collective Llc 3929 Airport Blvd Ste 2-204 Mobile AL 36609-2241 Ph: (251) 480-0070  | 
| NPI Number | 1740984368 | 
|---|---|
| Provider Enumeration Date | 03/28/2023 | 
| Last Update Date | 08/14/2023 | 
| Certification Date | 08/14/2023 | 
| Medicare PECOS PAC ID | 6800252628 | 
|---|---|
| Medicare Enrollment ID | O20230828000384 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1740984368 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary | 
| 101Y00000X | Counselor | (* (Not Available)) | Primary | 
| Provider Name | Carl H Hickey | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1801089149 PECOS PAC ID: 0749255206 Enrollment ID: I20040827001063  | 
| Provider Name | Bayani Abordo | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1881696540 PECOS PAC ID: 9133154669 Enrollment ID: I20051003000857  | 
| Provider Name | Christine Reno | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1013100502 PECOS PAC ID: 6608958434 Enrollment ID: I20080131000485  | 
| Provider Name | Tina I Baker | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1396886867 PECOS PAC ID: 1759466568 Enrollment ID: I20080304000442  | 
| Provider Name | Jeffrey John Pappas | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1124186671 PECOS PAC ID: 0840352324 Enrollment ID: I20081217000251  | 
| Provider Name | Valerie Schofield | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1871968206 PECOS PAC ID: 2264775550 Enrollment ID: I20190530002265  | 
| Provider Name | Serena La Nimityongskul | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1831584168 PECOS PAC ID: 4284998097 Enrollment ID: I20190619002693  | 
| Provider Name | Dustin R Harrison | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1043623929 PECOS PAC ID: 9436469509 Enrollment ID: I20191120003258  | 
| Provider Name | Pilar Courtney Bendolph | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1588285621 PECOS PAC ID: 9537526595 Enrollment ID: I20230606002746  | 
| Provider Name | Katherine A Cooper-lawton | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1235811399 PECOS PAC ID: 5890158372 Enrollment ID: I20230831000493  | 
| Provider Name | Elizabeth Ann Wood | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1699101360 PECOS PAC ID: 7315395571 Enrollment ID: I20231128003050  | 
| Provider Name | Emily Blankenship | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1013334713 PECOS PAC ID: 3375996499 Enrollment ID: I20240125000502  | 
| Provider Name | Justin Bender | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1770511172 PECOS PAC ID: 9830532837 Enrollment ID: I20240207000113  | 
| Provider Name | Ellen Odom | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1578588471 PECOS PAC ID: 9234572272 Enrollment ID: I20240207001315  | 
| Provider Name | Julius M Ritchie | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1922039718 PECOS PAC ID: 3274976683 Enrollment ID: I20240213000301  | 
| Provider Name | Erin T Difate | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1548301096 PECOS PAC ID: 7618110362 Enrollment ID: I20240329001887  | 
| Provider Name | Amanda Christine Howard | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1538904016 PECOS PAC ID: 2567991508 Enrollment ID: I20250121002283  | 
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