Provider Demographics
NPI:1962231936
Name:MENTAL WELLNESS THERAPY GROUP, PLLC
Entity type:Organization
Organization Name:MENTAL WELLNESS THERAPY GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & LEAD CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:810-845-8784
Mailing Address - Street 1:7440 NEFF RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:MI
Mailing Address - Zip Code:48458-1836
Mailing Address - Country:US
Mailing Address - Phone:810-845-8784
Mailing Address - Fax:
Practice Address - Street 1:7440 NEFF RD
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:MI
Practice Address - Zip Code:48458-1836
Practice Address - Country:US
Practice Address - Phone:810-845-8784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty