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Contact Information

EARTHWALK WELLNESS GROUP, LLC
14050 NORTH 83RD AVENUE
SUITE 290
PEORIA, AZ85381
 Phone: 480-349-1031
 Fax: 623-321-1565
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for EARTHWALK WELLNESS GROUP, LLC

NPI # 1568934107
LBN Legal business name EARTHWALK WELLNESS GROUP, LLC
Authorized official KYRIE THOMPSON - (MANAGING MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/20/2018
Last updated 12/20/2018 - About 7 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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