# MENTAL WELLNESS CLUB LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184305898
- **Authorized official:** MS. AWNEE MITCHELL MA LMFT PPS (OWNER)
- **Authorized official phone:** (209) 471-3856

## Contact information

- **Practice address:** 510 S FAIRMONT AVE SUITE 2, LODI, CA 95240
- **Practice address phone:** (209) 471-3856
- **Practice address fax:** (209) 644-7606
- **Mailing address:** 7627 RIVER OTTER WAY, ELK GROVE, CA 95758
- **Mailing address phone:** (209) 471-3856
- **Mailing address fax:** (209) 644-7606

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 07/26/2023
- **Last updated:** 07/26/2023