Mental Wellness Group, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MENTAL WELLNESS GROUP, LLC

Practice address

9990 Coconut Rd
Estero, FL 34135-8488

Phone

(239) 390-1161

NPI assigned

Dec 16, 2015

Organization subpart

No

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

Authorized official

Name

Jill Rae Brewer, LCSW

Title

Owner/Clinician

Phone

(239) 390-1161

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1450224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470787200000",
    "number": "1083079115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9990 COCONUT RD",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "341358488",
            "telephone_number": "239-390-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9990 COCONUT RD",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "341358488",
            "telephone_number": "239-390-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL WELLNESS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-16",
        "last_updated": "2016-08-10",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "239-390-1161",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin John McKenna, M.D.
• Medfit, LLC
• Tyler Emerson Mellecker, PTA
• Eluar Mendez Hernandez
• Javier Mendez
• Meredyth Acri PT LLC
• Glen Franklin Metrick, PHYSICAL THERAPIST
• Taylor Lawless Meyer, RDN, CSO, LDN
• William Floyd Meyer, PA-C, MMS, MPH
• Stephania Medeje Michaud, RN, BSN, IBCLC

• Clinical Social Worker in Estero, FL
• Providers in Estero, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; 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.