Provider Demographics
NPI:1518721570
Name:MADE WELL COUNSELING AND WELLNESS PLLC
Entity Type:Organization
Organization Name:MADE WELL COUNSELING AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINZE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:469-850-0095
Mailing Address - Street 1:212 E BROADWAY ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-2935
Mailing Address - Country:US
Mailing Address - Phone:469-850-0095
Mailing Address - Fax:
Practice Address - Street 1:212 E BROADWAY ST UNIT 1
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-2935
Practice Address - Country:US
Practice Address - Phone:469-850-0095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty