Provider Demographics
NPI:1184029290
Name:ATWELLS WELLNESS CENTER
Entity Type:Organization
Organization Name:ATWELLS WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-709-7147
Mailing Address - Street 1:414 WOODRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5821
Mailing Address - Country:US
Mailing Address - Phone:267-709-7147
Mailing Address - Fax:
Practice Address - Street 1:414 WOODRIDGE DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5821
Practice Address - Country:US
Practice Address - Phone:267-709-7147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007757101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty