Provider Demographics
NPI:1245806710
Name:MOTIVATED WELLNESS SOLUTIONS, LLC
Entity Type:Organization
Organization Name:MOTIVATED WELLNESS SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITKE
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S, LICDC
Authorized Official - Phone:740-233-6357
Mailing Address - Street 1:303 TOWNSHIP ROAD 208 N
Mailing Address - Street 2:
Mailing Address - City:DE GRAFF
Mailing Address - State:OH
Mailing Address - Zip Code:43318-9745
Mailing Address - Country:US
Mailing Address - Phone:740-233-6357
Mailing Address - Fax:
Practice Address - Street 1:185 S LIBERTY ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7619
Practice Address - Country:US
Practice Address - Phone:740-233-6357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1730561036Medicaid