# 12 STEPS WELLNESS LIVING

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

## Provider details

- **NPI number:** 1225610603
- **Authorized official:** KIMESHA CLARKE NP (NP)
- **Authorized official phone:** (347) 210-5064

## Contact information

- **Practice address:** 4522 CLARENDON RD, BROOKLYN, NY 11203-5218
- **Practice address phone:** (347) 210-5064
- **Mailing address:** 4522 CLARENDON RD, BROOKLYN, NY 11203-5218
- **Mailing address phone:** (347) 210-5064

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/25/2021
- **Last updated:** 09/11/2025