Actualized Holistic Wellness, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

ACTUALIZED HOLISTIC WELLNESS, LLC

Practice address

504 N Dupont Hwy
Dover, DE 19901-3961

Phone

(302) 566-7245

Fax

(302) 336-9957

NPI assigned

Feb 28, 2019

Last updated

Apr 2, 2025By 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. Jennifer Patrice Edwards, PH.D., LPCMHNPI 1427598465

Title

Owner

Phone

(302) 566-7245

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Jennifer Patrice Edwards, PH.D.,LPCMH

  • Mental Health Counselor
  • Dover, DE
  • NPI 1427598465

  Professional

  NPD Authorized official

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1538626239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 N DUPONT HWY",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013961",
            "telephone_number": "302-566-7245",
            "fax_number": "302-336-9957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N DUPONT HWY",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013961",
            "telephone_number": "302-566-7245",
            "fax_number": "302-336-9957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTUALIZED HOLISTIC WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-28",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "PATRICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-566-7245",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., LPCMH"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Dover, DE
• Providers in Dover, DE by specialty
• Professional Counselor in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.

Verify at the official NPI Registry.