Provider Demographics
NPI:1306483979
Name:NATURAL WELLNESS CLINICS, LLC
Entity type:Organization
Organization Name:NATURAL WELLNESS CLINICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDING PARTNER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOMMIE
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:BENEFIELD
Authorized Official - Suffix:JR
Authorized Official - Credentials:LHC
Authorized Official - Phone:904-563-0332
Mailing Address - Street 1:1468 PLAINFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-3923
Mailing Address - Country:US
Mailing Address - Phone:904-563-0332
Mailing Address - Fax:
Practice Address - Street 1:3000 FERN VALLEY RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40213-3522
Practice Address - Country:US
Practice Address - Phone:904-563-0332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty