Provider Demographics
NPI:1558025023
Name:MENTAL SWELLNESS
Entity Type:Organization
Organization Name:MENTAL SWELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:434-303-2300
Mailing Address - Street 1:490 BUENA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:HALIFAX
Mailing Address - State:VA
Mailing Address - Zip Code:24558-2152
Mailing Address - Country:US
Mailing Address - Phone:973-769-5681
Mailing Address - Fax:
Practice Address - Street 1:5037 HALIFAX RD STE U4
Practice Address - Street 2:
Practice Address - City:HALIFAX
Practice Address - State:VA
Practice Address - Zip Code:24558-3243
Practice Address - Country:US
Practice Address - Phone:434-303-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-29
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty