Provider Demographics
NPI:1467615906
Name:WELLNESS COUNSELING CENTER
Entity Type:Organization
Organization Name:WELLNESS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:I
Authorized Official - Last Name:MARKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-307-8950
Mailing Address - Street 1:PO BOX 253
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91376-0253
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:165 E HIGH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-1102
Practice Address - Country:US
Practice Address - Phone:818-307-8950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-04
Last Update Date:2008-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45861106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty