Provider Demographics
NPI:1497414015
Name:ARIEL WALLEN LLC
Entity Type:Organization
Organization Name:ARIEL WALLEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:716-445-9097
Mailing Address - Street 1:62 PINE ST
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-1828
Mailing Address - Country:US
Mailing Address - Phone:716-445-9097
Mailing Address - Fax:
Practice Address - Street 1:62 PINE ST
Practice Address - Street 2:
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907-1828
Practice Address - Country:US
Practice Address - Phone:716-445-9097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health