| 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 |
|---|---|---|---|
| 101Y00000X | Counselor | () | Primary |
| 1041C0700X | Social Worker - Clinical | () | Secondary |
| Provider Name | William C Wilkerson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962445056 PECOS PAC ID: 8123912003 Enrollment ID: I20040211000757 |
| 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 | Stephanie M Garrard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427086859 PECOS PAC ID: 8820035686 Enrollment ID: I20050413000284 |
| Provider Name | Julie T Trice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184626905 PECOS PAC ID: 7113968397 Enrollment ID: I20050518000373 |
| 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 | Harold R Veits |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508811969 PECOS PAC ID: 4486995552 Enrollment ID: I20190418001202 |
| Provider Name | Valerie Schofield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871968206 PECOS PAC ID: 2264775550 Enrollment ID: I20190530002265 |
| Provider Name | Serena L 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 | Holli J Hosford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740914670 PECOS PAC ID: 8628446994 Enrollment ID: I20221116002974 |
| 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 | Rebekah Rayburn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467967620 PECOS PAC ID: 1850741588 Enrollment ID: I20231221001137 |
| 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 | Carl Thurman Mcnatt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033441472 PECOS PAC ID: 2466899059 Enrollment ID: I20240319000553 |
| 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 |
| Provider Name | Laceola Holmes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407581671 PECOS PAC ID: 0446763205 Enrollment ID: I20250703001300 |
| Provider Name | Nicole Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619136645 PECOS PAC ID: 1153506068 Enrollment ID: I20260131000303 |
| Provider Name | Martha Mitchell |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1316833015 PECOS PAC ID: 9335620178 Enrollment ID: I20260219004359 |
| Provider Name | Laura Kate Inman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427938836 PECOS PAC ID: 0941785448 Enrollment ID: I20260402001106 |
| Provider Name | Lisa M Boster |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1295973469 PECOS PAC ID: 4385119668 Enrollment ID: I20260406001254 |
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