Provider Demographics
NPI:1871095513
Name:STUART MENTAL HEALTH AND WELLNESS, LLC
Entity type:Organization
Organization Name:STUART MENTAL HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:FITZGERALD
Authorized Official - Last Name:HELLMANN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:772-486-7249
Mailing Address - Street 1:PO BOX 118
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34991-0118
Mailing Address - Country:US
Mailing Address - Phone:772-763-9540
Mailing Address - Fax:844-296-7702
Practice Address - Street 1:1207 SW SUNSET TRL
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-3342
Practice Address - Country:US
Practice Address - Phone:772-486-7249
Practice Address - Fax:833-485-0447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW11131101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty