Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Provenance Substance Abuse & Wellness Centers LLC

Organization Mental Health Clinic/Center (Including Community Mental Health Center) · NPI 1649976945

Provenance Substance Abuse & Wellness Centers LLC is a Mental Health Clinic/Center (Including Community Mental Health Center) in Glen Allen, Virginia. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4870 Sadler Rd Pmb #8903 Ste 300
Glen Allen, VA 23060
Phone: (480) 442-9819
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Clinic/Center (Including Community Mental Health Center) (primary) Taxonomy 261QM0801X
Substance Use Disorder Rehabilitation Clinic/Center Taxonomy 261QR0405X

Record details

NPI number1649976945
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Devolis Newburn — Owner · (480) 442-9819
NPI enumeratedFebruary 7, 2023
Last updated in NPPESAugust 20, 2024
Certification dateAugust 20, 2024
Mailing address4870 Sadler Rd Pmb #8903, Suite 300, Glen Allen, VA 23060

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