Provider Demographics
NPI:1629840426
Name:SUNDEW THERAPY AND WELLNESS LLC
Entity Type:Organization
Organization Name:SUNDEW THERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUMATE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:302-440-5084
Mailing Address - Street 1:260 CHAPMAN RD STE 205A
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5449
Mailing Address - Country:US
Mailing Address - Phone:302-440-5084
Mailing Address - Fax:
Practice Address - Street 1:260 CHAPMAN RD STE 205A
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5449
Practice Address - Country:US
Practice Address - Phone:302-440-5084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty