Organization
WELLNESS 365, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIRGINIA JOHNSON EDD (EXECUTIVE DIRECTOR)
(559) 352-3000
Entity
Organization
Contact information
Practice address
300 CREEK VIEW RD STE 209, NEWARK, DE 19711-8548
(302) 709-1257
Mailing address
PO BOX 27274, FRESNO, CA 93729-7274
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
03/11/2022
Last updated
03/11/2022
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