Provider Demographics
NPI:1093250540
Name:CIRCLE OF WELLNESS LLC
Entity type:Organization
Organization Name:CIRCLE OF WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:LONNELL
Authorized Official - Middle Name:F
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:434-806-3869
Mailing Address - Street 1:9321 MIDLOTHIAN TPKE STE C
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4941
Mailing Address - Country:US
Mailing Address - Phone:804-252-4525
Mailing Address - Fax:
Practice Address - Street 1:9321 MIDLOTHIAN TPKE STE C
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4941
Practice Address - Country:US
Practice Address - Phone:804-252-4525
Practice Address - Fax:804-597-0213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904009706251S00000X
251S00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty