Organization Active NPI

Wellness Clinique, LLC

  • Mental Health Counselor
  • Orlando, FL
National Provider Identifier
1629596499
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WELLNESS CLINIQUE, LLC
Practice address
6900 Tavistock Lakes Blvd Ste 400
Orlando, FL 32827-7593
Phone
(407) 717-2147
NPI assigned
Aug 31, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Authorized official

Name
Jay Epstein
Title
Manager
Phone
(215) 715-9519

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

6900 Tavistock Lakes Blvd Ste 400
Orlando, FL 32827-7593

Mailing address

13381 Beebe Aly
Orlando, FL 32827-7667
Phone (407) 717-2147

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1629596499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13381 BEEBE ALY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277667",
            "telephone_number": "407-717-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 TAVISTOCK LAKES BLVD STE 400",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277593",
            "telephone_number": "407-717-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS CLINIQUE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-31",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "EPSTEIN",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "215-715-9519"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.