Provider Demographics
NPI:1154829430
Name:EMOTIONAL WELLNESS COUNSELING
Entity Type:Organization
Organization Name:EMOTIONAL WELLNESS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE-MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRETTINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:727-479-8787
Mailing Address - Street 1:10710 SEMINOLE BLVD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-3316
Mailing Address - Country:US
Mailing Address - Phone:727-479-8787
Mailing Address - Fax:
Practice Address - Street 1:10710 SEMINOLE BLVD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-3316
Practice Address - Country:US
Practice Address - Phone:727-479-8787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty