Provider Demographics
NPI:1215527106
Name:WELLNESS INITIATIVE
Entity type:Organization
Organization Name:WELLNESS INITIATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCHLUDE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:910-200-3163
Mailing Address - Street 1:908 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:PROSPECT PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19076-2014
Mailing Address - Country:US
Mailing Address - Phone:910-200-3163
Mailing Address - Fax:
Practice Address - Street 1:318 W BALTIMORE AVE STE 3
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3791
Practice Address - Country:US
Practice Address - Phone:610-638-0010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)