| Name: | The Wellness Group, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 27 Feb 2008 (17 years ago) (Companies founded in February 2008) |
| Entity Number: | 000-416-631 |
| Register Number: | 000416631 |
| ZIP code: | 35045 (Companies in Chilton, 35045) |
| County: | Chilton |
| Place of Formation: | Chilton County |
| Principal Address: | CLANTON, AL |
| Registered Office Street Address: | 311 DEBRA AVECLANTON, AL 35045 |
Activities
SOCIAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1932456134 | 2012-08-07 | 2013-12-03 | 232 TOWN MART, CLANTON, AL, 350453784, US | 232 TOWN MART, CLANTON, AL, 350453784, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 205-280-7733 |
| Fax | 2052807733 |
Authorized person
| Name | MR. JEREMY MICHAEL SMITH |
| Role | PARTNER |
| Phone | 2052807733 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | 2723 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 101YP2500X - Professional Counselor |
| License Number | 2723 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 103K00000X - Behavior Analyst |
| License Number | 2723 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | 1406 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 106H00000X - Marriage & Family Therapist |
| License Number | 2723 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 51131358 |
| State | AL |
| Issuer | VALUEOPTIONS |
| Number | 719746 |
| State | AL |
| Issuer | MEDICAID |
| Number | 1932456134 |
| State | AL |
| Name | Role |
|---|---|
| SMITH, JEREMY M | Member |
| SMITH, DAWN L | Member |
| Name | Role |
|---|---|
| SMITH, JEREMY M | Agent |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
