Provider Demographics
NPI:1053062992
Name:SUNNY E WELLS
Entity Type:Organization
Organization Name:SUNNY E WELLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUNNY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:931-444-7213
Mailing Address - Street 1:270 TURNBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6336
Mailing Address - Country:US
Mailing Address - Phone:931-220-7646
Mailing Address - Fax:
Practice Address - Street 1:133 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-3437
Practice Address - Country:US
Practice Address - Phone:931-444-1213
Practice Address - Fax:931-999-1443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty