Mental Wellness Club LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

MENTAL WELLNESS CLUB LLC

Practice address

510 S Fairmont Ave Suite 2
Lodi, CA 95240

Phone

(209) 471-3856

Fax

(209) 644-7606

NPI assigned

Jul 26, 2023

Last updated

Jul 26, 2023By 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

Ms. Awnee Mitchell, MA LMFT PPSNPI 1659768851

Title

Owner

Phone

(209) 471-3856

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Awnee Mitchell

  • Marriage & Family Therapist
  • Lodi, CA
  • NPI 1659768851
  NPD Authorized official
• Saleema Nathifa Ali, AMFT, APCC

  • Marriage & Family Therapist
  • Lodi, CA
  • NPI 1841055258
  NPD (past)

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1184305898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7627 RIVER OTTER WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "95758",
            "telephone_number": "209-471-3856",
            "fax_number": "209-644-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S FAIRMONT AVE SUITE 2",
            "city": "LODI",
            "state": "CA",
            "postal_code": "95240",
            "telephone_number": "209-471-3856",
            "fax_number": "209-644-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL WELLNESS CLUB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "AWNEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-471-3856",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA LMFT PPS"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mirella Medina
• Harry R Meeks Jr., AMFT
• Monica Mendiola
• Ana Beatriz Mendoza Bautista
• Regina Irma Mendoza
• Victoria Sibayan Merck, M.F.T.
• Lauri K. Merrill, P.T.
• Todd M. Merrill, P.T.
• Ciera Noele Mertens, MS
• Zachary Mertz

• Marriage & Family Therapist in Lodi, CA
• Providers in Lodi, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; 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.