Provider Demographics
NPI:1437933199
Name:CENTER FOR INTEGRATED COUNSELING AND WELLNESS
Entity Type:Organization
Organization Name:CENTER FOR INTEGRATED COUNSELING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MIRELA
Authorized Official - Middle Name:
Authorized Official - Last Name:FODOR-NAGY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPP-S
Authorized Official - Phone:347-531-4099
Mailing Address - Street 1:4801 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-7901
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7235 SAWMILL RD STE 101
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-5003
Practice Address - Country:US
Practice Address - Phone:347-531-4099
Practice Address - Fax:614-376-0517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty