Provider Demographics
NPI:1972367878
Name:WELLNESS SOLUTIONS GROUP LLC
Entity type:Organization
Organization Name:WELLNESS SOLUTIONS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARTNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:303-385-3669
Mailing Address - Street 1:14552 STARGAZER DR
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-8773
Mailing Address - Country:US
Mailing Address - Phone:303-385-3669
Mailing Address - Fax:
Practice Address - Street 1:2900 E 136TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-3542
Practice Address - Country:US
Practice Address - Phone:303-385-3669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty