Addiction Wellness Center in LLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

ADDICTION WELLNESS CENTER IN LLC

Practice address

202 E Maple St
Jeffersonville, IN 47130-3420

Phone

(812) 850-0619

Fax

(317) 458-1794

NPI assigned

Aug 24, 2026

Last updated

Aug 24, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

ADDICTION WELLNESS CENTER IN LLCAs reported in NPPES

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

Authorized official

Name

Jessie Costley

Title

Credentialing Manager

Phone

(443) 452-3149

Specialties & licenses 2

Addresses

Tax ID family

Addiction Wellness in LLC2 organizations share this tax ID, including this one

Part of

Addiction Wellness in LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Addiction Wellness Center in LLC

  • Nurse Practitioner
  • Jeffersonville, IN
  • NPI 1720703382
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Addiction Wellness Center in LLC

  • Nurse Practitioner
  • Jeffersonville, IN
  • NPI 1720703382
  NPPES parent name

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

{
    "created_epoch": "1787529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787529600000",
    "number": "1740197136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BUSINESS PKWY S STE 1",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211573048",
            "telephone_number": "812-850-0619",
            "fax_number": "317-458-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E MAPLE ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303420",
            "telephone_number": "812-850-0619",
            "fax_number": "317-458-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDICTION WELLNESS CENTER IN LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADDICTION WELLNESS CENTER IN LLC",
        "enumeration_date": "2026-08-24",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A",
        "authorized_official_last_name": "COSTLEY",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "443-452-3149"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Acton, RBT
• Michelle Adams, LMHC
• Amelia Adamson, RBT
• Adaptive Hospice, LLC (St Croix Hospice)
• Addiction Wellness Center in LLC
• Titilayo Adeniyan
• Yetunde Adeyinka-de'Leon, MSSW
• Advanced Regional Surgery Center, LLC
• Aegis Group Practice LLC
• Anthony Aemmer II, APRN

• Physician Assistant in Jeffersonville, IN
• Providers in Jeffersonville, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.