The Life Wellness Clinic, PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

THE LIFE WELLNESS CLINIC, PLLC

Practice address

6551 Stage Oaks Dr Ste 3
Bartlett, TN 38134-3895

Phone

(901) 497-1823

NPI assigned

May 30, 2023

Last updated

Sep 24, 2023By 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

Heather Delay, APRN, FNP-CNPI 1790383438

Title

Co-Owner

Phone

(901) 497-1823

Specialties & licenses 3

Addresses

Locations

Practitioners 4

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.

• Heather Delay, APRN, FNP-C

  • Nurse Practitioner
  • Memphis, TN
  • NPI 1790383438
  NPD Authorized official
• Leanna Elizabeth Baldner, LPC-MHSP

  • Professional Counselor
  • Memphis, TN
  • NPI 1801610456
  NPD (past)
• Andrea Jean Davis, LPC

  • Professional Counselor
  • Nashville, TN
  • NPI 1255521662
  NPD (past)
• Aaron Michael Delay, LPC, MHSP

  • Professional Counselor
  • Bartlett, TN
  • NPI 1811682206
  NPD (past)

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

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695513600000",
    "number": "1659064285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3814 AARON CV",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381351929",
            "telephone_number": "901-878-9355",
            "fax_number": "901-295-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6551 STAGE OAKS DR STE 3",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381343895",
            "telephone_number": "901-497-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LIFE WELLNESS CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-09-24",
        "certification_date": "2023-09-24",
        "status": "A",
        "authorized_official_last_name": "DELAY",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "901-497-1823",
        "authorized_official_credential": "APRN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Bartlett, TN
• Providers in Bartlett, TN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2023; 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.