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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

PREMIER WELLNESS CENTER LLC
NPI 1629864061
Counselor - Professional in Media, PA

Active since April 15, 2025
511 N PROVIDENCE RD, REAR ENTRANCE, MEDIA, PA 19063(484) 363-9280(484) 205-4950 Get Directions Write a Review

NPPES record last updated: September 21, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 21, 2026, Jun 2, 2026 (2 updates tracked since 2026).

About Premier Wellness Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREMIER WELLNESS CENTER LLC (NPI 1629864061) is a healthcare organization registered as a professional in Media, Pennsylvania and active in the NPI registry since April 2025. The organization lists Amanda Koniewicz, Owner, as its authorized official.

NPPES Registry Identity

NPI1629864061
Entity TypeOrganization
Primary Taxonomy101YP2500X
Legal Business NamePREMIER WELLNESS CENTER LLC
Location Address511 N PROVIDENCE RD, REAR ENTRANCEMedia, PA 19063-2518
Mailing Address511 N Providence Rd, Rear EntranceMedia, PA 19063-2518 · (484) 363-9280 · Fax (484) 205-4950
Phone(484) 363-9280
Fax(484) 205-4950
Organization SubpartNo
Authorized OfficialAmanda KoniewiczOwner · (484) 363-9280
Enumeration DateApril 15, 2025
Last NPPES UpdateSeptember 21, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 21, 2026
✔ NPI 1629864061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X
511 N PROVIDENCE RD, Media, PA 19063
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KARLY CASTILLO MA
Counselor (Mental Health)
511 N PROVIDENCE RD, REAR ENTRANCE
MEDIA, PA 19063
Delaware County (484) 442-0073
BRUCE LOCKETT LSW
Social Worker
511 N PROVIDENCE RD, REAR ENTRANCE
MEDIA, PA 19063
Delaware County (484) 442-0073
SARAH HEUTZ MS
Counselor (Mental Health)
511 N PROVIDENCE RD, REAR ENTRANCE
MEDIA, PA 19063
Delaware County (484) 442-0073
DARA ELBAUM LSW
Social Worker
511 N PROVIDENCE RD, REAR ENTRANCE
MEDIA, PA 19063
Delaware County (484) 442-0073
RACHAEL TOBINUS MS
Counselor (Mental Health)
511 N PROVIDENCE RD, REAR ENTRANCE
MEDIA, PA 19063
Delaware County (484) 442-0073
MICHAEL CLEMENS DMD
Dentist
511 N PROVIDENCE RD
MEDIA, PA 19063
Delaware County (610) 565-0525
DR. ANIER DIAZ VIDAL DMD
Dentist
511 N PROVIDENCE RD
MEDIA, PA 19063
Delaware County (610) 565-0525
DR. AMANDA KONIEWICZ PSY.D, LPC
Counselor (Professional)
511 N PROVIDENCE RD, REAR ENTRANCE
MEDIA, PA 19063
Delaware County (484) 363-9280

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 Premier Wellness Center LLC's NPI number?

The NPI number for Premier Wellness Center LLC is 1629864061. It was assigned to this organization in the NPPES registry on April 15, 2025.

Where is Premier Wellness Center LLC located?

Premier Wellness Center LLC is located at 511 N Providence Rd Rear Entrance, Media, PA 19063. The listed phone number is (484) 363-9280.

What is Premier Wellness Center LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Premier Wellness Center LLC was last updated on September 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 days 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.