Active NPI
Adolescent Wellness Academy LLC
- Adolescent and Children Mental Health Clinic/Center
- Davie, FL
National Provider Identifier
1386471084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adolescent and Children Mental Health Clinic/Center
- Legal business name
- ADOLESCENT WELLNESS ACADEMY LLC
- Practice address
- 4900 S University Dr Ste 204
Davie, FL 33328-3811 - Phone
- (561) 816-9023
- Fax
- (954) 368-1345
- NPI assigned
- Sep 17, 2024
- Last updated
- Dec 29, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dustin Johnson
- Title
- Ceo
- Phone
- (561) 816-9023
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | NU | Primary | |
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | NU |
Addresses
Primary practice location
4900 S University Dr Ste 204
Davie, FL 33328-3811
Mailing address
4900 S University Dr Ste 204
Davie, FL 33328-3811
Phone (561) 816-9023
National Provider Directory
National Provider Directory- Tax ID family
- Adolescent Wellness Academy LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adolescent and Children Mental Health Clinic/Center
- Coconut Creek, FL
- NPI 1235095704
-
- Adolescent and Children Mental Health Clinic/Center
- Miami, FL
- NPI 1427914993
Locations
4343 S State Road 7
Ste 103
Davie, FL 33314
4900 S University Dr
Ste 204
Davie, FL 33328
Phone (561) 816-9023
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726531200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1766966400000",
"number": "1386471084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4900 S UNIVERSITY DR STE 204",
"city": "DAVIE",
"state": "FL",
"postal_code": "333283811",
"telephone_number": "561-816-9023",
"fax_number": "954-368-1345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 S UNIVERSITY DR STE 204",
"city": "DAVIE",
"state": "FL",
"postal_code": "333283811",
"telephone_number": "561-816-9023",
"fax_number": "954-368-1345"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADOLESCENT WELLNESS ACADEMY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-09-17",
"last_updated": "2025-12-29",
"certification_date": "2025-12-29",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "DUSTIN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "561-816-9023"
},
"taxonomies": [
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.