Provider Demographics
NPI:1083332357
Name:BE WELL CHRISTIAN COUNSELING AND LIFE SERVICES LLC
Entity Type:Organization
Organization Name:BE WELL CHRISTIAN COUNSELING AND LIFE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLANAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:276-701-2388
Mailing Address - Street 1:PO BOX 571
Mailing Address - Street 2:
Mailing Address - City:GRUNDY
Mailing Address - State:VA
Mailing Address - Zip Code:24614-0571
Mailing Address - Country:US
Mailing Address - Phone:276-701-2388
Mailing Address - Fax:
Practice Address - Street 1:1048 PINE CONE RD # 581
Practice Address - Street 2:
Practice Address - City:GRUNDY
Practice Address - State:VA
Practice Address - Zip Code:24614-6634
Practice Address - Country:US
Practice Address - Phone:276-701-2388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health