Provider Demographics
NPI:1922566553
Name:THE INSTITUTE FOR RELATIONSHIP WELLNESS & SEXUAL HEALTH PC
Entity Type:Organization
Organization Name:THE INSTITUTE FOR RELATIONSHIP WELLNESS & SEXUAL HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:678-538-6450
Mailing Address - Street 1:2790 SKYPARK DR STE 307
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5388
Mailing Address - Country:US
Mailing Address - Phone:855-878-5325
Mailing Address - Fax:
Practice Address - Street 1:2255 CUMBERLAND PKWY SE BLDG 500-140
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-4524
Practice Address - Country:US
Practice Address - Phone:855-878-5325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-02
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty