Wellness Place, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904006847 Issued in VA

Legal business name

WELLNESS PLACE, LLC

Practice address

622 Main St
Warsaw, VA 22572-4280

Phone

(804) 238-0383

Fax

(866) 639-3167

NPI assigned

Nov 11, 2009

Last updated

Jun 6, 2024By 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

Mrs. Mary Hunter Sudduth, L.C.S.W.NPI 1295975902

Title

President

Phone

(804) 238-0383

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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.

• Mary Hunter Sudduth, L.C.S.W.

  • Clinical Social Worker
  • Warsaw, VA
  • NPI 1295975902
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1851628911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 MAIN ST",
            "city": "WARSAW",
            "state": "VA",
            "postal_code": "225724280",
            "telephone_number": "804-238-0383",
            "fax_number": "866-639-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 MAIN ST",
            "city": "WARSAW",
            "state": "VA",
            "postal_code": "225724280",
            "telephone_number": "804-238-0383",
            "fax_number": "866-639-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-11",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "SUDDUTH",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "HUNTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-238-0383",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #17922)
• Warsaw Family Dentistry Inc.
• Warsaw Recovery Center
• Warsaw Smile Dental Inc.
• Warsaw SNF Operations LLC (Northern Neck Senior Care Community)
• Tina R Welsh, L.P.N.
• Stephanie Hope White, LPC
• Teresa G Williams, NP

• Clinical Social Worker in Warsaw, VA
• Providers in Warsaw, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.