Provider Demographics
NPI:1376250159
Name:EASE & WELLNESS COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:EASE & WELLNESS COUNSELING SERVICES LLC
Other - Org Name:EASE & WELLNESS COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TANISHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:LISAC, LAADC, AADC
Authorized Official - Phone:520-230-5174
Mailing Address - Street 1:315 W VALENCIA RD UNIT 22661
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85734-4668
Mailing Address - Country:US
Mailing Address - Phone:520-230-5174
Mailing Address - Fax:
Practice Address - Street 1:218 E PLACITA LAGO DEL MAGO
Practice Address - Street 2:
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85629
Practice Address - Country:US
Practice Address - Phone:520-230-5174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty