Provider Demographics
NPI:1811581879
Name:PERSON CENTERED MENTAL WELLNESS, LLC
Entity Type:Organization
Organization Name:PERSON CENTERED MENTAL WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS-DEHMER
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:317-358-9022
Mailing Address - Street 1:14074 TRADE CENTER DR STE 205
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-4573
Mailing Address - Country:US
Mailing Address - Phone:317-358-9022
Mailing Address - Fax:317-779-2947
Practice Address - Street 1:14074 TRADE CENTER DR STE 205
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-4573
Practice Address - Country:US
Practice Address - Phone:317-779-2947
Practice Address - Fax:317-981-1714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-21
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)