Organization
ANCHORED IN WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUNA MATTINGLY LCSW (OWNER)
(912) 530-8889
Entity
Organization
Contact information
Practice address
311 E CHERRY ST, JESUP, GA 31546-4872
(912) 530-8889
(912) 598-6109
Mailing address
311 E CHERRY ST, JESUP, GA 31546-4872
(912) 530-8889
(912) 598-6109
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003662
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112252915A
—
GA
Enumeration date
11/03/2015
Last updated
11/01/2016
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