AUTHENTIC SELF COMPLETE WELLNESS PLLC
NPI 1063255537
Nurse Practitioner - Psychiatric/Mental Health in Harrisonburg, VA
About Authentic Self Complete Wellness Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AUTHENTIC SELF COMPLETE WELLNESS PLLC (NPI 1063255537) is a healthcare organization registered as a psychiatric/mental health in Harrisonburg, Virginia and active in the NPI registry since June 2024. The organization lists Carey Dean, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Authentic Self Complete Wellness Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Authentic Self Complete Wellness PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Authentic Self Complete Wellness PLLC's NPI number?
The NPI number for Authentic Self Complete Wellness PLLC is 1063255537. It was assigned to this organization in the NPPES registry on June 13, 2024.
Where is Authentic Self Complete Wellness PLLC located?
Authentic Self Complete Wellness PLLC is located at 1012 Reservoir St Ste A, Harrisonburg, VA 22801. The listed phone number is (540) 324-3435.
What is Authentic Self Complete Wellness PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Authentic Self Complete Wellness PLLC enrolled in Medicare?
Yes. Authentic Self Complete Wellness PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Authentic Self Complete Wellness PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Authentic Self Complete Wellness PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Authentic Self Complete Wellness PLLC was last updated on March 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Authentic Self Complete Wellness Pllc · NPI 1063255537
Psychiatric/Mental Health organization in Harrisonburg, Virginia. Organization record, active in the CMS NPPES registry since June 13, 2024.
## Identity
- **NPI:** 1063255537 (Entity type: Organization)
- **Enumerated:** June 13, 2024
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Carey Dean, OWNER
## Practice location
- **Address:** 1012 RESERVOIR ST STE A, Harrisonburg, VA 22801-4457
- **Phone:** (540) 324-3435
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 7, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1063255537) · Data from the CMS NPPES public registry.