Provider Demographics
NPI:1730933128
Name:ART OF WELLNESS MENTAL HEALTH CARE
Entity type:Organization
Organization Name:ART OF WELLNESS MENTAL HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-841-0806
Mailing Address - Street 1:28 GOULDS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PASSADUMKEAG
Mailing Address - State:ME
Mailing Address - Zip Code:04475-3115
Mailing Address - Country:US
Mailing Address - Phone:618-841-0806
Mailing Address - Fax:
Practice Address - Street 1:28 GOULDS RIDGE RD
Practice Address - Street 2:
Practice Address - City:PASSADUMKEAG
Practice Address - State:ME
Practice Address - Zip Code:04475-3115
Practice Address - Country:US
Practice Address - Phone:618-841-0806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty