Provider Demographics
NPI:1376903666
Name:BEHAVIORAL HEALTH AND WELLNESS SOLUTIONS
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH AND WELLNESS SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:317-710-0354
Mailing Address - Street 1:3100 N DAVIDSON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-1080
Mailing Address - Country:US
Mailing Address - Phone:773-865-0477
Mailing Address - Fax:215-754-4649
Practice Address - Street 1:1020 ANNABRANCH TRCE
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-5755
Practice Address - Country:US
Practice Address - Phone:773-865-0477
Practice Address - Fax:215-754-4649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health