Provider Demographics
NPI:1962160887
Name:ALJ WELLNESS PLLC
Entity type:Organization
Organization Name:ALJ WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:JUSTINE
Authorized Official - Last Name:HUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DBH, CCTP-II, LMFT
Authorized Official - Phone:843-892-9393
Mailing Address - Street 1:448 CUMMINGS ST STE 199
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-3220
Mailing Address - Country:US
Mailing Address - Phone:843-892-9393
Mailing Address - Fax:
Practice Address - Street 1:19265 TRIPLE CROWN DR
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24211-6667
Practice Address - Country:US
Practice Address - Phone:843-892-9393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty