Organization · Type 2 NPI

Divine Design Psychiatry and Wellness PLLC

Psychiatric/Mental Health Nurse Practitioner · O Fallon, IL

NPI number 1104779750 Active

Practice location

853 Chesapeake Junction Ln
O Fallon, IL 62269-7035

Call (217) 816-7928 Map

Fax (616) 208-2675

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XNone listed

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

About NPI 1104779750

Divine Design Psychiatry and Wellness PLLC's National Provider Identifier is 1104779750, issued on Feb 16, 2026. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in O Fallon, IL. The record was last updated on May 18, 2026.