| Wellness House | |
|
9 Polk St Sparta NJ 07871-2713 | |
| (210) 563-5228 | |
| Not Available |
| Full Name | Wellness House |
|---|---|
| Speciality | Social Worker |
| Location | 9 Polk St, Sparta, New Jersey |
| Authorized Official Name and Position | Asim Husain (CO-OWNER) |
| Authorized Official Contact | 2032937603 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness House 9 Polk St Sparta NJ 07871-2713 Ph: (210) 563-5228 | Wellness House 9 Polk St Sparta NJ 07871-2713 Ph: (210) 563-5228 |
| NPI Number | 1932950441 |
|---|---|
| Provider Enumeration Date | 04/01/2024 |
| Last Update Date | 09/13/2024 |
| Certification Date | 09/13/2024 |
| Medicare PECOS PAC ID | 0042751455 |
|---|---|
| Medicare Enrollment ID | O20240925000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932950441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amina Ellrott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700441193 PECOS PAC ID: 9032650841 Enrollment ID: I20240919004280 |
| Provider Name | Asim Husain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881234532 PECOS PAC ID: 2668859109 Enrollment ID: I20240925001397 |
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