Provider Demographics
NPI:1841845757
Name:ANALYTIC WELLNESS CENTER LLC
Entity type:Organization
Organization Name:ANALYTIC WELLNESS CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CRATIA
Authorized Official - Middle Name:CRASHIA
Authorized Official - Last Name:STOCKTON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA/LBA
Authorized Official - Phone:276-224-6730
Mailing Address - Street 1:764 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-0263
Mailing Address - Country:US
Mailing Address - Phone:276-224-6730
Mailing Address - Fax:
Practice Address - Street 1:1087 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-4506
Practice Address - Country:US
Practice Address - Phone:276-224-6730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-07
Last Update Date:2025-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty