The Wellness Collaborative

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0717001246 Issued in VA

Legal business name

THE WELLNESS COLLABORATIVE

Practice address

1664 Chestwood Dr
Virginia Beach, VA 23453-7064

Phone

(757) 412-7753

Fax

(757) 301-6920

NPI assigned

Oct 13, 2014

Last updated

Oct 13, 2014By 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

Dr. Jonathan Eric Smith, PHD, LMFT

Title

Owner

Phone

(757) 412-7753

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413158400000",
    "number": "1396149829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6892",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560892",
            "telephone_number": "757-412-7753",
            "fax_number": "757-301-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 CHESTWOOD DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234537064",
            "telephone_number": "757-412-7753",
            "fax_number": "757-301-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WELLNESS COLLABORATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-13",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-412-7753",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "0717001246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; 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.