Provider Demographics
NPI:1396610275
Name:THE WELLNESS VINEYARD
Entity type:Organization
Organization Name:THE WELLNESS VINEYARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHANDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCGHEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:469-269-0791
Mailing Address - Street 1:900 N PRESTON RD STE 50-173
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-8786
Mailing Address - Country:US
Mailing Address - Phone:469-269-0791
Mailing Address - Fax:
Practice Address - Street 1:1402 S CUSTER RD STE 903
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75072-1455
Practice Address - Country:US
Practice Address - Phone:469-269-0791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty