ADOLESCENT WELLNESS ACADEMY LLC – NPI #1235095704
Clinic/Center

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

Health Care Provider Taxonomy Code for Clinic/Center

ADOLESCENT WELLNESS ACADEMY LLC is an AHC clinic located in COCONUT CREEK, FL. NPPES has assigned the NPI number 1235095704 to ADOLESCENT WELLNESS ACADEMY LLC on December 29, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QM0855X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Adolescent and Children Mental Health

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ADOLESCENT WELLNESS ACADEMY LLC below.

NPI Profile for
ADOLESCENT WELLNESS ACADEMY LLC

NPI Number
1235095704
Enumeration Date

(about 5 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ADOLESCENT WELLNESS ACADEMY LLC
Primary location
4611 JOHNSON RD STE A06
COCONUT CREEK, FL 33073-4361
Phone: (561) 816-9023 Fax: (954) 368-1345
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DUSTIN JOHNSON
CEO
Phone: (561) 816-9023
Updated
Certification Date
Dec 29, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM0855X
- Clinic/Center / Adolescent and Children Mental Health (Primary)
261QR0405X
- Clinic/Center / Rehabilitation, Substance Use Disorder

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.