OrganizationActive
Wellness Boutique, LLC
NPI 1134062482 · Mental Health Clinic/Center (Including Community Mental Health Center) · Henrico, VA
Provider details
- NPI number
- 1134062482
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Ebony Glover-Epps, Owner(804) 762-0079
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2807 N Parham Rd Ste 320
Henrico, VA 23294-4458
Phone: (540) 525-6155
Street-level locationGet directions
Mailing address
2807 N Parham Rd
Henrico, VA 23294
Registry dates
- Enumerated
- 2026-04-13
- Last updated
- 2026-04-13
- Certified
- 2026-04-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.