Provider Demographics
NPI:1841722741
Name:CENTER FOR SEXUAL HEALTH & WELLNESS, LLC
Entity type:Organization
Organization Name:CENTER FOR SEXUAL HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHASITY
Authorized Official - Middle Name:SHANELL
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, MCAP, ICADC,
Authorized Official - Phone:772-245-7608
Mailing Address - Street 1:1860 SW FOUNTAINVIEW BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-4528
Mailing Address - Country:US
Mailing Address - Phone:772-208-7834
Mailing Address - Fax:495-774-6179
Practice Address - Street 1:1860 SW FOUNTAINVIEW BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-4528
Practice Address - Country:US
Practice Address - Phone:772-208-7834
Practice Address - Fax:495-774-6179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-30
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12547101Y00000X, 101YP2500X, 101YM0800X
FLMCAP10044101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty