Provider Demographics
NPI:1033718010
Name:THE WAY COMMUNITY BEHAVIORAL WELLNESS CENTER
Entity Type:Organization
Organization Name:THE WAY COMMUNITY BEHAVIORAL WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, LADC
Authorized Official - Phone:612-594-6530
Mailing Address - Street 1:7038 BROOKLYN BLVD STE G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-1370
Mailing Address - Country:US
Mailing Address - Phone:763-291-0540
Mailing Address - Fax:
Practice Address - Street 1:7038 BROOKLYN BLVD STE G
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-1370
Practice Address - Country:US
Practice Address - Phone:763-291-0540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty