Provider Demographics
NPI:1033760020
Name:HOLISTIC COUNSELING AND WELLNESS, LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:HOLISTIC COUNSELING AND WELLNESS, LIMITED LIABILITY COMPANY
Other - Org Name:HOLISTIC WELLNESS OF SOUTH FLORIDA, LIMITED LIABILITY COMPANY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LARKIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, LMHC, RN
Authorized Official - Phone:617-650-0785
Mailing Address - Street 1:1600 PLEASANT CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-4431
Mailing Address - Country:US
Mailing Address - Phone:617-650-7850
Mailing Address - Fax:
Practice Address - Street 1:100 SAUNDERS RD STE 150
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-2526
Practice Address - Country:US
Practice Address - Phone:617-650-7850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-22
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty