Provider Demographics
NPI:1033985213
Name:WHOLE SELF COUNSELING LLC
Entity Type:Organization
Organization Name:WHOLE SELF COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:815-207-1278
Mailing Address - Street 1:3135 N BOLANDER RD
Mailing Address - Street 2:
Mailing Address - City:GENOA
Mailing Address - State:OH
Mailing Address - Zip Code:43430-9739
Mailing Address - Country:US
Mailing Address - Phone:815-207-1278
Mailing Address - Fax:
Practice Address - Street 1:119 W 2ND ST
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-1471
Practice Address - Country:US
Practice Address - Phone:815-207-1278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty