Atlantic Wellness Group, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

ATLANTIC WELLNESS GROUP, LLC

Practice address

139 E Buckingham Dr
Rehoboth Beach, DE 19971-1467

Phone

(302) 270-6992

NPI assigned

Aug 18, 2022

Last updated

Aug 18, 2022By 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

Mary Vaughn Moor, PSY.D.

Title

Member

Phone

(302) 270-6992

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1255059937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 E BUCKINGHAM DR",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199711467",
            "telephone_number": "302-270-6992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 E BUCKINGHAM DR",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199711467",
            "telephone_number": "302-270-6992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC WELLNESS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "VAUGHN MOOR",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "302-270-6992",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Rehoboth Beach, DE
• Providers in Rehoboth Beach, DE by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.