Goddess Health & Wellness, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

GODDESS HEALTH & WELLNESS, LLC

Practice address

5420 Hollywood Blvd Apt 111
Hollywood, FL 33021-6481

Phone

(754) 300-7591

Fax

(954) 206-0496

NPI assigned

Apr 25, 2020

Last updated

Apr 25, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tomeka Conswello Davis

Title

Owner/Founder/Member Manager

Phone

(954) 848-7104

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• T. Conswello Davis

  • Mental Health Counselor
  • Hollywood, FL
  • NPI 1770135972
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1587772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587772800000",
    "number": "1043830425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4223",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333384223",
            "telephone_number": "754-300-7591",
            "fax_number": "954-206-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 HOLLYWOOD BLVD APT 111",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216481",
            "telephone_number": "754-300-7591",
            "fax_number": "954-206-0496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15800 NW 42nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miami Gardens",
            "state": "FL",
            "postal_code": "330546155",
            "country_code": "US",
            "telephone_number": "305-626-3138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GODDESS HEALTH & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-25",
        "last_updated": "2020-04-25",
        "certification_date": "2020-04-25",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "TOMEKA",
        "authorized_official_middle_name": "CONSWELLO",
        "authorized_official_title_or_position": "OWNER/FOUNDER/MEMBER MANAGER",
        "authorized_official_telephone_number": "954-848-7104"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.