Provider Demographics
NPI:1093321994
Name:SPECTRUM MENTAL WELLNESS, LLC
Entity Type:Organization
Organization Name:SPECTRUM MENTAL WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KERI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BRESSETTE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:256-466-6385
Mailing Address - Street 1:201 BOB WALLACE AVE SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3810
Mailing Address - Country:US
Mailing Address - Phone:256-642-7400
Mailing Address - Fax:256-642-7600
Practice Address - Street 1:201 BOB WALLACE AVE SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3810
Practice Address - Country:US
Practice Address - Phone:256-642-7400
Practice Address - Fax:256-642-7600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-17
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)