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Organization
BODHI WELLNESS, LLC
Active
Organization
BODHI WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON COULSON NP (OWNER)
(757) 239-5858
Entity
Organization
Contact information
Practice address
1331 WILLOW WOOD DR, NORFOLK, VA 23509-1303
(757) 239-5858
Mailing address
4901 COLLEY AVE, NORFOLK, VA 23508-2067
(757) 681-6634
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/12/2025
Last updated
05/13/2025
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