Divine Mental Wellness PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

DIVINE MENTAL WELLNESS PLLC

Practice address

3202 Delaford Dr
Carrollton, TX 75007-3036

Phone

(682) 800-3809

NPI assigned

Feb 26, 2025

Organization subpart

No

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

Authorized official

Name

Chioma AnwukahNPI 1881245322

Title

Authorized Official

Phone

(682) 800-3809

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, FL, VA3 enrollments

Enrollment records 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chioma Anwukah

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1881245322

  FL, Single Specialty, TX, VA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1740528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743638400000",
    "number": "1083411243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 DELAFORD DR",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750073036",
            "telephone_number": "682-800-3809",
            "fax_number": "682-316-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3202 DELAFORD DR",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750073036",
            "telephone_number": "682-800-3809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Diligence Dr Ste 202B",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064272",
            "country_code": "US",
            "telephone_number": "682-800-3809",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 36th St",
            "address_purpose": "LOCATION",
            "city": "Vero Beach",
            "state": "FL",
            "postal_code": "329604862",
            "country_code": "US",
            "telephone_number": "682-800-3809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DIVINE MENTAL WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-26",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A",
        "authorized_official_last_name": "ANWUKAH",
        "authorized_official_first_name": "CHIOMA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "682-800-3809"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincent Dirusso, DDS
• Jason Diu
• Dalton Divakaran
• Diversified Healthcare-Dallas LLC
• Divine Edge Health Services LLC
• DLRC Ancillary Services, LLC
• DLS Rehab Services Inc.
• DMM Lab LLC
• Matthew Tuan Doan
• Doctors Healthcare on the Go LLC

• Psychiatric/Mental Health Nurse Practitioner in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.