Provider Demographics
NPI:1992429732
Name:WORTHWHILE WELLNESS, PLLC
Entity type:Organization
Organization Name:WORTHWHILE WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GUSTAFSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:906-241-9164
Mailing Address - Street 1:2402 W FARRAND RD
Mailing Address - Street 2:
Mailing Address - City:CLIO
Mailing Address - State:MI
Mailing Address - Zip Code:48420-1014
Mailing Address - Country:US
Mailing Address - Phone:906-241-9164
Mailing Address - Fax:
Practice Address - Street 1:2402 W FARRAND RD
Practice Address - Street 2:
Practice Address - City:CLIO
Practice Address - State:MI
Practice Address - Zip Code:48420-1014
Practice Address - Country:US
Practice Address - Phone:906-241-9164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)