Provider Demographics
NPI:1235728734
Name:WELLNESS FAMILY COUNSELING, PLLC
Entity Type:Organization
Organization Name:WELLNESS FAMILY COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:VOVILLIA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:303-847-9172
Mailing Address - Street 1:9451 SHELLWAY DR NW
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49676-8401
Mailing Address - Country:US
Mailing Address - Phone:303-847-9172
Mailing Address - Fax:
Practice Address - Street 1:9451 SHELLWAY DR NW
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:MI
Practice Address - Zip Code:49676-8401
Practice Address - Country:US
Practice Address - Phone:303-847-9172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty