Organization
COMMUNITY WELLNESS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIRLYN MARIA GARRETT-WILSON ED.D., LCPC (VICE PRESIDENT OF CLINICAL SERVICES)
(773) 320-9592
Entity
Organization
Contact information
Practice address
635 ARGYLE AVE, FLOSSMOOR, IL 60422-1201
(773) 844-8813
Mailing address
635 ARGYLE AVE, FLOSSMOOR, IL 60422-1201
(773) 844-8813
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19002
—
IL
Enumeration date
10/26/2020
Last updated
05/04/2022
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