# RECLAIM WELLNESS GROUP

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

## Provider details

- **NPI number:** 1831874023
- **Authorized official:** CLEMENT STREET RUSSELL PSYD (CO-OWNER)
- **Authorized official phone:** (502) 777-3188

## Contact information

- **Practice address:** 4010 DUPONT CIR STE 600, LOUISVILLE, KY 40207-4883
- **Practice address phone:** (502) 758-9878
- **Mailing address:** 4010 DUPONT CIR STE 600, LOUISVILLE, KY 40207-4883
- **Mailing address phone:** (502) 758-9878

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | Yes |
| 103T00000X | Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 06/16/2023
- **Last updated:** 06/16/2023