Provider Demographics
NPI:1043869118
Name:ANCHORED WELLNESS LLC
Entity Type:Organization
Organization Name:ANCHORED WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP-BC, BSN,
Authorized Official - Phone:864-315-1617
Mailing Address - Street 1:128 MILLPORT CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5573
Mailing Address - Country:US
Mailing Address - Phone:864-315-1617
Mailing Address - Fax:864-402-8764
Practice Address - Street 1:128 MILLPORT CIR STE 200
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5573
Practice Address - Country:US
Practice Address - Phone:864-315-1617
Practice Address - Fax:864-402-8764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC22058OtherSTATE LICENSE