Wellus LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

WELLUS LLC

Practice address

505 Old York Road
Suite 107
Jenkintown, PA 19046-1904

Phone

(267) 307-9700

Fax

(267) 307-9700

NPI assigned

Jun 25, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carmella Charlene Jackson, LPCNPI 1902288764

Title

Ceo

Phone

(267) 307-9700

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.

• Carmella Jackson, LPC

  • Mental Health Counselor
  • Jenkintown, PA
  • NPI 1902288764
  NPD Authorized official

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561420800000",
    "number": "1538720057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7973 THOURON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191502520",
            "telephone_number": "267-237-0042",
            "fax_number": "267-907-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 OLD YORK ROAD",
            "address_2": "SUITE 107",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190461904",
            "telephone_number": "267-307-9700",
            "fax_number": "267-307-9700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 S 4th St Ste 240A",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191471573",
            "country_code": "US",
            "telephone_number": "267-307-9700",
            "fax_number": "267-907-1120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELLUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-06-25",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CARMELLA",
        "authorized_official_middle_name": "CHARLENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "267-307-9700",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Weiner
• Martin Weisberg, MD
• Don M Weiss, D.C.
• Michael Alan Weiss, D.D.S.
• Mark Weizer
• White Pearl Dentistry PLLC (Jenkintown Smiles Dental)
• Stashagay Whitfield
• Sharee Wicks
• Ryan Wiggon
• Aleksandra Wilkowski, COTA/L

• Community/Behavioral Health Agency in Jenkintown, PA
• Providers in Jenkintown, PA by specialty
• Community/Behavioral Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.