Provider Demographics
NPI:1497231658
Name:WELLNESS AND EDUCATION GROUP, INC
Entity Type:Organization
Organization Name:WELLNESS AND EDUCATION GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AFSANEH
Authorized Official - Middle Name:YOCHEVED
Authorized Official - Last Name:BALAKHANEH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:310-270-5523
Mailing Address - Street 1:5315 LAUREL CANYON BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-4916
Mailing Address - Country:US
Mailing Address - Phone:310-270-5523
Mailing Address - Fax:
Practice Address - Street 1:5315 LAUREL CANYON BLVD STE 201
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-4916
Practice Address - Country:US
Practice Address - Phone:310-270-5523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28730261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)