Provider Demographics
NPI:1114781010
Name:TOTAL WELLNESS MENTAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:TOTAL WELLNESS MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KANISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELT
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:757-761-5815
Mailing Address - Street 1:136 CARTWELL DR APT 101
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1420
Mailing Address - Country:US
Mailing Address - Phone:757-761-5815
Mailing Address - Fax:
Practice Address - Street 1:249 CENTRAL PARK AVE STE 300-160
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3099
Practice Address - Country:US
Practice Address - Phone:757-761-5815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty